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^^N//H-^4^.A2/K//^ 



NOV 5 1990 



The 
NORTH CAROLINA 

REGISTER 



IN THIS ISSUE 






FINAL DECISION LETTER 

PROPOSED RULES 

CPA Examiners 

Environment, Health, and Natural Resources 

Human Resources 

Midwifery Joint Committee 

Nursing, Board of 

State Personnel 

ARRC OBJECTIONS 

RULES INVALIDATED BY JUDICIAL DECISION 

ISSUE DATE: NOVEMBER I, 1990 
Volume 5 • Issue 15 • Pages 957-1009 



INFORMATION ABOUT THE NORTH CAROLINA REGISTER AND ADMINISTRATIVE CODE 



NORTH CAROLINA REGISTER 

The Sorth Carolina Register is published bi-monthly 
and contains information relating to agency, executi\e, 
legislative and judicial actions required b>' or affecting 
Chapter 150B of the General Statutes. All proposed, ad- 
ministrative rules and amendments filed under Chapter 
150B must be published in the Register. The Register 
will t\picallv comprise appro.ximateK' fift>' pages per 
issue of legal text. 

State law requires that a copy of each issue be pro- 
vided free of charge to each county in the state and to 
various state officials and institutions. The North Carolina 
Register is a\ailable by yearly subscription at a cost of 
one hundred and five dollars (S105.00) for 24 issues. 

Requests for subscriptions to the Sorth Carolina 
Register should be directed to the Office of Ad- 
ministrati\e Hearings, P. O. Drawer 1 1666, Raleigh, X. 
C. 27604, .-^ttn: Siibscriptiotis. 

ADOPTION, AMENDMExNT, AND REPEAL OF 
RULES 

.An agency intending to adopt, amend, or repeal a rule 
must first publish notice of the proposed action in the 
North Carolina Register. The notice must include the 
time and place of the public hearing; a statement of how 
public comments may be submitted to the agenc>' either 
at the hearing or otherwise; the text of the proposed 
rule or amendment; a reference to the Statutory 
Authority for the action and the proposed effective date. 

The Director of the Office of .Administratixe Hearings 
has authority to publish a summary, rather than the 
full text, of any amendment which is considered to be 
too lengthy. In such case, the full text of the rule con- 
taining the proposed amendment will be a\"ailable for 
public inspection at the Rules Di\ision of the Office of 
Administrati\"e Hearings and at the office of the pro- 
mulgating agency. 

Unless a specific statute pro\ ides otherwise, at least 
30 days must elapse following publication of the pro- 
posal in the North Carolina Register heiore the agenc\" 
may conduct the required public hearing and take ac- 
tion on the proposed adoption, amendment or repeal. 

When final action is taken, the promulgating agency 
must file any adopted or amended rule for appro\al b>' 
the .•\dministrati\e Rules Re\ie\\ Commission. Upon ap- 
proA'al of ARRC, the adopted or amended rule must be 
filed with the Office of .Administrative Hearings. If it 
differs substantially from the proposed form published 
as part of the public notice, upon request by the agen- 
cy, the adopted \ersion will again be published in the 
North Carolina Register. 

A rule, or amended rule cannot become effecti\-e 
earlier than the first day of the second calendar month 
after the adoption is filed with the Office of Ad- 
ministrative Hearings for publication in the NCAC. 

Proposed action on rules may be withdrawn h\ the 
promulgating agency at any time before final action is 
taken by the agencN'. 

TE.MPORARY RULES 

Under certain conditions of an emergencv nature, 
some agencies may issue temporary rules. A temporary' 
rule becomes effective when adopted and remains in 



effect for the period specified in the rule or 180 days, 
whichever is less. An agency adopting a temporarv rul 
must begin normal rule-making procedures on the pei 
manent rule at the same time the temporarv rule i 
adopted. 

NORTH CAROLINA ADxMINISTRATIVE CODE 

The North Carolina Administrative Code (NCAC) is 
a compilation and index of the administrative rules of 
25 state agencies and 38 occupational licensing boards 
The XC.AC comprises approximately 15,000 letter size 
single spaced pages of material of which approximate 
ly 35% is changed annually. Compilation and publica 
tion of the NCAC is mandated by G.S. 150B-63(b) 

The Code is divided into Titles and Chapters. Each 
state agency is assigned a separate title which is fur 
ther broken down by chapters. Title 21 is designatec 
for occupational licensing boards. 

The NCAC is a\ailable in two formats. 

(1) Single pages may be obtained at a minimurr 
cost of two dollars and 50 cents (S2.50) for IC 
pages or less, plus fifteen cents (SO. 1 5) per eacl 
additional page. 

(2) The full publication consists of 52 volumes 
totaling in excess of 15,000 pages. It is sup 
plemented monthly with replacement pages, t 
one year subscription to the full publication in 
eluding supplements can be purchased fo 
seven hundred and fifty dollars (S750.00). In 
di\idual \olumes may also be purchased wit! 
supplement service. Renewal subscriptions fo 
supplements to the initial publication available 

Requests for pages of rules or \'olumes of the NCA( 
should be directed to the Office of Administrativ 
Hearings. 

NOTE 

The foregoing is a generalized statement of the pre 
cedures to be folloued. For specific statutory- languagi 
it is suggested that Articles 2 and 5 of Chapter 150B o 
the General Statutes be examined carefully. 

CITATION TO THE NORTH CAROLINA 
REGISTER 

The North Carolina Register is cited bv \olume, issu( 
page number and date. 1:1 NCR 101-201, April 1, 198 

refers to Volume 1, Issue 1, pages 101 through 201 i 
the North Carolina Register issued on April 1, 1986 



North Carolina Register. Published bi-monthly by 
the Office of Administrative Hearings, P.O. Drawer 
11666, Raleigh, North Carolina 27604, pursuant to 
Chapter 150B of the General Statutes. Subscriptions 
one hundred and five dollars (SI 05.00) per year. 
North Carolina Administrative Code. Published 
in looseleaf notebooks with supplement ser\'ice by 
the Office of Administrati\e Hearings, P.O. 
Drawer 11 666, Raleigh, North Carolina 27604, pur- 
suant to Chapter 150B of the General Satutes. 
Subscriptions seven hundred and fifty dollars 
(S750.00). Individual volumes available. 



I 



\ 



NORTH 
CAROLINA 
REGISTER 



ISSUE CONTENTS 




Office of Administrative Hearings 
P. O. Drawer 11666 
Raleigh. \C 27604 

(919) 733 - 2678 



I. FINAL DECISION LETTER 

Votiriii Riiihts Act 957 



II. PROPOSED RULES 

Environment, Health, and 
Natural Resources 

Coastal Management 979 

Water Treatment Facility 

Operators 983 

Human Resources 

Facility Services 958 

Social Services 976 

Licensing Boards 

CPA Fxammers 983 

Midwifery Joint 
Committee 994 

Nursing, Board of 994 

State Personnel 

State Personnel Commission ... 996 



Julian Mann III, 

Director 
James R. Scarcclla Sr., 

Deputy Director 
Molly \lasich, 

Director APA Services 



Staff: 

Ruby Creech, 

Publications Coordinator 
Teresa Kilpatrick, 

Editorial Assistant 
Jean Shirley, 

Editorial Assistant 



III. ARRC OBJECTIONS 1001 

I\ . RULES INA ALIDATED BY 

JUDICIAL DECISION 1005 

V. CUMULATIVE INDEX 1007 



NORTH CAROLINA REGISTER 

Publication Schedule 

(April 1990 - December 199/ J 



Issue 


Last Day 


Last Day 


Earliest 


* 


Date 


for 


for 


Date for 


Earliest 




Filing 


Electronic 


PubUc 


Effective 






Filing 


Hearing & 
Adoption by 
Agency 


Date 


++++*+*+ 


++++*+++ 


******** 


+**++**+ 


+++++++< 


04'02'90 


03/12/90 


03/19/90 


05/02/90 


08/01/90 


04/16/90 


03/23/90 


03/30/90 


05/16/90 


08/01/90 


05/01/90 


04/09/90 


04/17/90 


05/31/90 


09/01/90 


05/15/90 


04/24,90 


05/01 '90 


06/14/90 


09/01/90 


06/01/90 


05/10/90 


05/17/90 


07/01/90 


10/01/90 


06' 15/90 


05/24/90 


06/01/90 


07/15/90 


10/01/90 


07/02/90 


06/11/90 


06/18/90 


08/01/90 


11/01/90 


07/16/90 


06/22/90 


06/29/90 


08/15/90 


11/01/90 


08/01/90 


07/11/90 


07/18/90 


08/31/90 


12/01/90 


08/15/90 


07/25/90 


08/01/90 


09/14/90 


12/01/90 


09/04/90 


08/13/90 


08/20/90 


10/04/90 


01/01/91 


09/14/90 


08/24/90 


08/31/90 


10/14/90 


01/01/91 


10/01/90 


09/10/90 


09/17/90 


10/31/90 


02/01/91 


10/15/90 


09/25,90 


10/02/90 


11/14/90 


02/01/91 


11/01/90 


10/11/90 


10/18/90 


11/30/90 


03/01/91 


11/15/90 


10/24/90 


10/31/90 


12/14/90 


03/01/91 


12/03/90 


11/08/90 


11/15/90 


01/02/91 


04 '01/91 


12/14/90 


11/21/90 


11/30/90 


01/13,91 


04/01/91 


01/02/91 


12/07/90 


12/14/90 


02,01/91 


05/01/91 


01/15/91 


12/20/90 


12/31/90 


02/14/91 


05/01/91 


02/01/91 


01/10/91 


01/17/91 


03/03/91 


06/01/91 


02/15/91 


01/25,91 


02/01/91 


03/17/91 


06/01/91 


03/01/91 


02/08/91 


02/15/91 


03,31/91 


07/01/91 


03/15/91 


02/22/91 


03/01/91 


04/14,91 


07/01/91 


04/01/91 


03/11/91 


03/18/91 


05/01,91 


08/01/91 


04/15/91 


03/22/91 


04/01/91 


05/15/91 


08/01/91 


05/01/91 


04/10 91 


04/17/91 


0531/91 


09/01/91 


05/15/91 


04/24,91 


05/01/91 


06:14/91 


09/01/91 


06/03 '91 


05/10/91 


05/17/91 


07 03/91 


10/01/91 


06/14/91 


05/23/91 


05/31/91 


07/14/91 


1001 91 


07/01/91 


06/10/91 


06/17/91 


07/31,91 


11/01/91 


07/15/91 


06'21/91 


06/28/91 


08/14/91 


11/01/91 


08/01/91 


07/11,91 


07/18/91 


08/31/91 


12/01/91 


08/15/91 


07/25/91 


08/01/91 


09/14/91 


12 '01/91 


09/03/91 


08/12/91 


08/19/91 


10 03 91 


01 01 92 


09/16/91 


08/23/91 


08/30/91 


10,16,91 


01/01 92 


10/01/91 


09/10/91 


09/17/91 


10 '31/91 


02 '01/92 


10/15/91 


09/24/91 


10/01 '91 


11 '14/91 


02/01/92 


11/01/91 


10/11/91 


10/18/91 


12 01/91 


03/01/92 


11/15/91 


10/24,91 


10/31/91 


12/15 91 


03 01 92 


12/02/91 


11/07,91 


11/14/91 


01/01/92 


04 01 92 


12/16/91 


11/21,91 


12/02,91 


01/15/92 


04/01/92 



* The "Earliest Effecthc Dale" is computed assuming that the public hearing 
and adoption occur in the calendar month immediately following the "Issue 
Date", that the agency files the ride with The Administratix'e Rules Re\'iew 
Commission by the 20th of the same calendar month and that ARRC approves 
the rule at the next calendar month meeting. 



VOTING RIGHTS ACT FINAL DECISION LETTER 



[G.S. I20-30.9H, effective July 16, 1986, requires that all letters and other documents issued by the 
Attorney General of the United States in which a final decision is made concerning a "change af- 
fecting voting" under Section 5 of the Voting Rights Act of 1965 be published in the North Carolina 
Register. / 



U.S. Department of Justice 
Civil Rights Division 

JRD:GS:TCR.rac 

DJ 166-012-3 Voting Section 

AI049-055 P.O. Box 66128 

AK255 Washington, D.C. 20035-6128 

September 24, 1990 

DeWitt F. McCarley, Esq. 

City Attorney 

P.O. Box 7207 

Greenville, North Carolma 27835-7207 

Dear Mr. McCarley: 

This refers to seven annexations [Ordinance Nos. 2185 and 2192 through 2197 (1990)| and the 
designation of the annexed areas to districts for the City of Greenville in Pitt County, North C^irolina, 
submitted to the Attorney General pursuant to Section 5 of the Voting Rights Act of 1965, as amended, 
42 U.S.C. 1973c. We received your submission on July 26, 1990. 

The Attorney General docs not interpose any objections to the changes in question. However, 
we feel a responsibility to point out that Section 5 of the Voting Rights Act expressly provides that the 
failure of the Attorney General to object does not bar any subsequent judicial action to enjoin the 
enforcement of such changes. See the Procedures for the Administration of Section 5 (28 C.F.R. 
51.41). 



Sincerely, 



John R. Dunne 

Assistant Attorney General 

CivU Ridits Division 



By: 



J. Gerald Hebert 

Acting Chief, Voting Section 



5:15 NORTH CAROLINA REGISTER November I, 1990 957 



PROPOSED RULES 



TITLE 10 - DKPARTMENT OF HUMAN 
RESOLRCES 



lyotice is hereby gh'cn in accordance with G.S. 
I SOB- 1 2 thai the Medical Care Commission in- 
tends to amend 10 .\CAC 3C .1901 - .1905, .1910. 
.1912. .1915 - .1916, .1918, .1922. .1926; 3H 
.0108. .0315, .0505, .0507, .05/0 - .0511, .0709. 
.1501. .1612; repeal rule fs) cited as 10 NCAC 3C 
.1913 - .1914; 3H .0107, .0508 - .0509; and adopt 
nde(s) cited as 10 A'C-JC 311 .0711, .1107 - 
.1109. 

1 he proposed effective date of this action is 
March 1. 1991. 

1 he public hearing will be conducted at 9:30 
a.m. on December 7, 1990 at the Di\ision of Fa- 
cility Sefyices, Hearing Room 201. 701 Barbour 
Drive (D. Dix Hospital Campus ). Raleigh, \orth 
Carolina 27603. 



Co 



■ omment Procedures: Written comments con- 
cerning the ndes should be submitted as soon as 
possible but no later than December ^ 1990 to 
Lynda McDaniel, 701 Barbour Drive. Raleigh. 
North Carolina 27603. Oral comments may be 
presented at the hearing. 

CH APTFR 3 - FACII ITY SERVICES 

SL IK HAITER 3C - I ICENSING OF 
HOSFMTALS 

SEC I ION .1900 - SI I'IM.EMEM AE Rl EES FOR 

THE EICENSL RE OF THE SKII LED: 

IMERMEDEVFE: DOMICILF\RY BEDS IN A 

HOSPFFAL 

.1901 SI I'PI KMENTAL RL LES 

When a hospital offers '. killed nursing facility 
int e rmediate ' or domiciliar\' home eewn* ** p**rt ei~ 
ite long term care services, the ser\'ices shall be 
included under one hospital license as provided 
in Rule .(1201(c). The general requirements in- 
cluded in this Subchapter shall apph" when ap- 
plicable but in addition the r i killed nursing 
intonnediutc facility care and domiciluiPv' home 
care unit must meet the supplemental require- 
ments of tliis Section. 

.■luthority G.S. 131E-79; 42 L.S.C. 1396. 

.1902 DEFINFFIONS 

The following dehnitions shall apply through- 
out tliis Section, unless text otherwise clearly m- 
dicates to the contrary': 



{ 1) "Accident" means something occurring by 
chance or without intention which has 
caused physical or mental harm to a patient, 
resident or employee. 

{2j "Administer" means the direct application 
of a drug to the body of a patient by in- 
jection, inhalation, iLngestion or other means. 

(3) "Administrator" means the person who 
has authonty for and is responsible to the 
governing board for the overall operation of 
a facility. 

(4) "Capacity" means the maximum number 
of patient or resident beds which the facility 
is licensed to maintain at any given time. 
This number shall be determined as follows: 

(a) Bedrooms shall have minimum square 
footage of 100 square feet for a single 
bedroom and 80 square feet per patient 
or resident in multi-bedded rooms. This 
minimum square footage shall not include 
space in toilet rooms, washrooms, closets, 
vestibules, corridors, and built-in furni- 
ture. 

(b) Diiung, recreation and common use areas 
available shall total no less than 25 square 
feet per bed for ' jkillod nursing ttft4 intijr 
modiato care beds and no less than 30 
square feet per bed for domiciliary home 
beds. Such space must be contiguous to 
patient and resident bedrooms. 

(5) "Combination Facility" means aw ho '. pi 
tei with nurving homL' bod ', which i^ licL ' ii '. L ' d 
to provid e mor e than fvfte k"n- ' l «4^ ea*^ '. uch 
a* a coinbinution b+ intL'nnL'duite twFt^ and or 
f . kilk'd nur ' ing ewfe iMvi domiciliar; . home 
care, a "combination home" as defined in 
the Nursing 1 lome 1 iccnsure .Act G.S. 
131F-II)1 (1). 

(6) "Commission" means the North Carolina 
Medical Care Commission unless otherwise 
specified. 

(7) "Convalescent Care" means care given for 
the purpose of assisting the patient or resi- 
dent to regain health or strength. 

(S) "Department" means the North Carolina 
Department of Human Resources. 

(^) "Director of Nursing" means the nurse 
who has authority and direct responsibility 
for all nursing services ;md nursing care. 
(10) "Dispense" means prepanng and packag- 
ing a prescription drug or device in a con- 
tainer and labeling the container with 
information required by state and ledcral 
law. filling or refilling drug containers with 
prescnption drugs for subsequent use by a 
patient is "dispensing". Providing quantities 
of unit dose prescription drugs for subse- 
quent administration is "dispensing". 



958 



5:15 NORTH CAROLINA REGISTER November I, 1990 



PROPOSED RULES 



(11) ''Domiciliar)' Home" means any facility 
by whatever name it is called and regardless 
of size which provides care for aged or disa- 
bled persons whose principal need is a home 
with the sheltered or personal care their age 
or disability requires. Medical care for any 
domiciliary home resident is only occasional 
or incidental such as may be required in the 
home of any individual or family, but the 
resident is supervised in the administration 
of his medications. 

(12) "Drug" means substances: 

(a) recognized in the official United States 
Pharmacopoeia, official National 
Formulary, or any supplement to any of 
them; 

(b) intended for use in the diagnosis, cure, 
mitigation, treatment, or prevention of 
disease in man or other animals; 

(c) mtcnded to affect the structure or any 
function of the body of man or other ani- 
mals, i.e., substances other than food; and 

(d) intended for use as a component of any 
article specified in (a), (b), or (c) of this 
Subparagraph; but does not include de- 
vices or their components, parts, or ac- 
cessories. 

(13) "Duly Licensed" means holding a current 
and valid license as required under the Gen- 
eral Statues of North Carolina. 

(14) "E>dsting Facility" means a licensed facil- 
ity; or a proposed facility, proposed addition 
to a licensed facility or proposed remodeled 
licensed facility that wiU be built according 
to plans and specifications which have been 
approved by the Department through the 
preliminary working drawings stage prior to 
the effecti\e date of this Rule. 

(15) "Exit Conference" means the conference 
held at the end of a survey, inspection or 
investigation, but prior to fmalizing the 
same, between the Department's represen- 
tatives who conducted the sur\'ey, inspection 
or investigation and the facility adminis- 
tration representative(s). 

(16) "Incident" means an intentional or unin- 
tentional action, occurrence or happening 
which is likely to cause or lead to physical 
or mental harm to a patient, resident or 
employee. 

(47^ "Intermediat e Car e Facility (ICFV means 
» facility H+ portion thereof. Innse' i er nam e d, 
' i shich » ad' i ertiiied. announced ef main 
tained fof tite e.xprei ' L i ef implied purpo! .e e+ 
presiding intennediate nuroing ea*© ef 
consale 'i cent etw* tof tliree »f more percon 
unrelated k* th«? hcenL . ee. 



(4-8)- "Intennodiat e Nurring" moans tfea* liȴel 
en'ic e which prcidoo fof counseling. 



ef 
t e achinc 



lifti^ implementing prec i cnbed 
treatment m »» intermediate eaw facility. 
U 'vr> miruotering te^ assisting with st¥¥^ main 
taining obsenant continuous eiife te the 
chronically ill «• a stabl e condition aft4 ift- 
olud e s administering medications; pro' i 'iding 
supporti' i e afi4 r e stt^ratise nursing proce 
dures k* those who t?«* benefit from such 
ser i icos: assisting with activities ef daily liv- 
iftgr maintaining foley catheters, colostomies 
aft4 ileostomies; aft4 providing fof aftv other 
condition which requires il*<* direction aft4 
supervision e# services by a licensed physi 
eia» aft4 provision &f senices by duly li- 
censod nursing personnel Bf W trained 
non licensed personnel under tke sup e r 
vision ef a duly licensed nurs e . 

(17) f4-0^ "Licensed Practical Nurse" means a 
nurse who is duly licensed as a practical 
nurse under G.S. 90, Article 9A. 

(18) f3% "Licensee" means the person, firm, 
partnership, association, corporation or or- 
ganization to whom a Ucense has been is- 
sued. 

(19) (-34^ "Medication" means drug as defined 
in (12) of tliis Rule. 

(20) (-i^ "New Facility" means a proposed fa- 
cihty, a proposed addition to an e>dstLng fa- 
cility or a proposed remodeled portion of an 
existing facility that is constructed according 
to plans and specit^ications approved by the 
Department subsequent to the effective date 
of this Rule. If determined by the Depart- 
ment that more than one half of an existing 
facility is remodeled, the entire existing fa- 
cility shall be considered a new facility. 

(21) Q^ "Nurse /Vide" means any unlicensed 
mal e t*f female person regardless of working 
title employed ef assigned m a facility f»f t4*e 
purpos e e+' assisting duly licens e d nurses 
with ptitient eafe &f providing patient eafe 
under tl*e super .' ision ef direction »f duly 
hcensed nurses, who is qualuled to pro\ide 
nursing care under the superMsion of a li^ 
censed nurse and is rcuistcred as a nurse aide 
in a nurse aide registr\ appro \ed by the De- 
partment. 

(22) "Nurse Aide Trainee" means an individual 



in trainintz to become a nurse aide. 



(23) "Nursing Facilit\" 



means that portion of 
a nursing home certified under rille .\I.\ of 
the Social Security .Act (.Medicaid) as in 
compliance with federal program standards 
for nursing facilities. It is often used as 
synon\mous with the term "nursing home" 



which IS the usual prerequisite level of state 



5:15 NORTH CAROLINA REGISTER November I. 1990 



959 



PROPOSED RULES 



licensure for nursing facility (NF) certif- 
ication and Medicare skilled nursing facility 
(SNF) certification. 

(24) "Nurse in Charge" means the nurse to 
whom duties for a specified number of pa- 
tients and staff for a specified period of time 
have been delegated, such as for Unit A on 
the 7-3 or 3-11 shift. 

(25) "On Duty" means personnel who are 
awake, dressed, responsive to patient needs 
and physically present in the facility per- 
forming assigned duties. 

(26) "Patient" means any person admitted for 
care to a skilled nursing or intermediate care 
facility. 

(27) "Physician" means a person licensed under 
G.S. Chapter 90, Article 1 to practice medi- 
cine in North Carolina. 

(28) "Qualified Dietitian" means a person who 
meets the standards and qualification estab- 
lished by the Committee on Professional 
Registration of the American Dietetic Asso- 
ciation. 

(29) "Registered Nurse" means a nurse who is 
duly licensed as a registered nurse under G.S. 
90, .Article 9A. 

(30) "Resident" means any person admitted for 
care to a domicili;u^' home. 

f34^ "Skilk'd Nur '. ing" mounf . Aa* Il ' soI evf !«h^ 
¥*«?# ' . ' . hich pro' i idLV . fop cc'un 'i i. ' ling. tL ' aching 
a«4 impk'monting pro ' ;^onbod troatmont m a- 
okilk ' d nuf ' jing facility- te » mini ' jtonng t^^ 
aoL . ir . ting with aft4 maintaining obL i Orsunt 
continuouF . eaf» te- tfet» chronically iH » a 
f . labk ' e* unstablij condition. .Such sop i Iclj 
includo ' j admini ' . ' tormg aU- modicution ' i ift- 
cludinu purenturol nicdicutiuns tt«4 
intra' ! e nou ' ' . lluidL . : pro' i iding supportivo aft4 
ro '. tHnUi' i L' nursing procijduror i U*f- tho - ' .e pa- 
ticMiti . ' . ' ■ ho WW- benefit from t ' Uch i i or' . iCL"; . : 
maintcuning awy tube ' : , indwelling » body 
ca' . iti e' ' . : admini '. te ^ ring oxygen h* other 
medicinal gaoos »» a regular basis te thos e 
patients ift a» uniUablo condition; aft4 re- 
quinng direction ef ! ' UpeP f n . ion trf senices 
by licen 'i ed physician '. a«4 deliver>' &f !i«m^ 
vices by licen '. od nursing p e rsonn e l &f 
trained non licensed nursing personnel «ft- 
4ef (4*e super . ision »f a licensed nurse 34 
hours pef 4ayT 

(43+ "Skilled Nursing Facility (SNF)" means a 
facihty »f a portion thereof hoi i vever ncuned, 
' ■ vhich is advertised, announced ef main 
tain e d ft*f t4+e express purpose t4 pro' . iding 
slalled iHU '. ing f^f con' . alescent eaw fef tliree 
©f more persons unr e lat e d te tfee licensee. 
4-bt^ primary need f>f (+h» patients admitted 



Vs skilled nursing ease »«• a 21 hour basis aR4 
continuing m e dical sup e rvision. 

(31) "Sitter" means an indi\idual employed to 
provide companionship and social inter- 
action to a particular resident or patient, 
usually on a pn\ate duty basis. 

(32) (44+ "Supenisor in Charge (sldUod nurs 
Lng)" "Super\isor-in-Charge" means a duly 
licensed nurse to whom supervisory duties 
have been delegated by the Director of 
Nursing. 

(44+ "Supenisor in Charge (intennediato eafe 
nursing)" means a duly licensed nurse fop 
eight hours p#F li^ betvreen tl*e hours ©f 
^?tQO a.m ' . aft4 ^^4W) p.m. Bfr a*- oth e r times, a 
non lic e u '.e d empk^yee te ' I ' l hom dutie '. ha' . o 
been delegated by (4*e director ef nursing. 

(33) (44+ "Supen.isor-in-Charge (domicUiary 
care facility)" means any employee to whom 
supervisory duties for the domicikary home 
portion of a combination facility have been 
delegated by either the administrator or di- 
rector of nursing. 

Authority G.S. J3/E-79; 42 U.S.C. 1396. 

.1903 INSPECTIONS 

(a) x\ny hospital with nursing homo beds li- 
censed by the Department under Section .1900 
of these Rules may be inspected by one or more 
authorized representatiyes of the Department at 
any time. Generally, inspections wiU be con- 
ducted between the hours of 8:00 a.m. and 6:00 
p.m., Monday through Friday. However, com- 
plaint investigations shall be conducted at the 
most appropriate time for investigating 
allegations of the complaint. 

(b) At the time of inspection, any authorized 
representatives of the Department shall make his 
presence known to the administrator or other 
person in charge who shall cooperate with such 
representative and facilitate the inspection. 

.■iuthority G.S. ISIE-^Q; 42 U.S.C. 13%. 

.1904 PROCEDLRE FOR .VPPE.VL 

A hospital with nursing facility or domiciliary' 
home beds may appeal any decision of the De- 
partment to deny, revoke or alter a license by 
making such an appeal in accordance with G.S. 
Chapter 150B. 

Authority G.S. /3/E-^9: 42 i'.S.C. 1396. 

.1905 .\D.MISSIONS 

(a) No' patient shall be admitted except under 
the orders of a duly licensed physician. 



960 



5:15 NORTH CAROLINA REGISTER November I, 1990 



PROPOSED RULES 



(b) The facility shall acquire prior to or at the 
time of admission orders from the attending 
physician for the immediate care of the patient 
or resident. 

(c) Within 48 hours of admission, the facility 
shall acquire medical information which shall in- 
clude current medical fmdtngs, diagnosis, reha- 
bilitation potential, a summary of the hospital 
stay if the patient is being transferred from a 
hospital, and orders for the ongoing care of the 
patient. 

(d) If a patient is admitted from somewhere 
other than a hospital, a physical examination 
shall be performed either within 5 days prior to 
admission or within 48 hours following admis- 
sion. 

(e) Hospitals offering oldllod nursing facility 
intormodiato nur ' jing, or domiciliary home care 
as a new service must prepare a plan of admission 
which, at a minimum, assures availability of staff 
time and plans for individual patient assessments, 
initiation of health care or nursing care plans, and 
implementation of physician and nursing treat- 
ment plans. This plan must be available for in- 
spection during the initial licensure sur\ey prior 
to issuance of a hcense. 

(f) Only person who are 1 8 years of age or older 
shall be admitted to domiciliary home beds in a 
facility. 

Authority G.S. I31E-79; 42 U.S.C. J 396. 

.1910 NLRSING/HF.ALTII CARE 

,\DM1MSTR.AT10\ .AND SLPERVISION 

(a) A licensed facility shall have a director of 
nursing service who shall be responsible for the 
overall organization and management of all 
nursing services in lildUcd nursing aft4 intomiodi 
*te 6»fe facilities and health care ser\'ices in the 
domiciliary home portion of combination facili- 
ties and shall be currently licensed to practice as 
a registered nurse by the North Carolina Board 
of Nursing in accordance with G.S. 90, Article 
9A. 

(b) The director of nursing shall not be counted 
as meeting the requirements for both the Director 
of Nursing and patient and resident care staffing 
contamed m Rules .1910, .1911 and .1912 of this 
Section. 

(c) The Director of Nursing shall not serve as 
administrator or assistant administrator. 

(d) A licensed facility with f4f sldilgd nursing 
facilities e* combination i . kilk'd nur '. ing. intor 
m e diat e safe ef domiciliary homoo shall provide 
a full-time director of nursing on duty at least 
eight hours per day, five days a week. A regis- 
tered nurse shall relieve the Director of Nursing 



(be in charge of nursing) during the Director's 
absence. 

(^ intormodiato ea* facilitiofi ef combination 
faciliti e s shall provide a diroctor ef nursing e» 
dtrty a* lea^ fo«f hours pef wook. Eithor a h- 
o e ns e d practical nurse »f rogistorod nurso shall be 
dooignatod a* m chorgo aft4 shall be ©ft duty t» 
the intormediate safe facility oight hours pe* dayr 
SQ' i 'on day* pep wook botwoon the hours ef ^iM^ 
a.m. aR4 7:00 p.m. At aH timos whon thoro i* aa 
absencQ si a registorod Bf liconsod practical nurso, 
thoro shall be a porson m chargo te whom dutios 
havo boon dologatod by the dir e ctor »f nursing. 

(e) A licensed facility shall employ and assign 
registered nurses, aft4 licensed practical nurses, 
aft4 non liconsod staff nurse aides and nurse aide 
trainees for duties in accord;mce with G.S. 90, 
/Vrticle 9A. The Depart mont shall refer possible 
violations »f tfeis statute te- the North Carolina 
Board &f Nursing fof investigation. 

(f) The Director of Nursing shall cause the 
following to be accomplished: 

(1) establishment and implementation of 
nursing poUcies and procedures which 
shall include, but shall not be limited to 
the foUowing: 

(A) assessment of and planning for patients' 
nursing care or health care needs, and im- 
plementation of nursing or health care 
plans; 

(B) daily charting of any unusual occur- 
rences or acute episodes related to patient 
care, and progress notes written monthly 
» SNFs aft4 quiirtorly tft ICFs reporting 
each patient's pertbrmance in accordance 
with identified goals and objectives and 
each patient's progress toward 
rehabilitative nursing goals; 

(C) assurance of the dcliver>' of nursing 
services in accordance with physicians' 
orders, nursing care plans and the facility's 
policies and procedures; 

(D) notification of emergency physicians 
or on-call physicians; 

(E) infection control to prevent cross- 
infection among patients and stall; 

(F) reporting of deaths; 

(G) emergency reporting of fire, patient and 
staff accidents or incidents, or other 
emergency situations; 

(H) use of protective devices or restraints 
to assure that each patient or resident is 
restrained in accordance with physician 
orders and the facility's policies, and that 
the restrained patient or resident is ap- 
propriately evaluated and released at a 
minimum of every two hours; 

(I) special skin care and decubite care; 



5:15 NORTH CAROLINA REGISTER November I, 1990 



961 



PROPOSED RULES 



(J ) bowel and bladder training; 

(K) maintenance of proper body alignment 
and restorative nursing care: 

(Lj supervision of and assisting patients 
with feeding: 

(Mj intake and output observation and re- 
porting for those patients whose condition 
warrants monitoring of their fluid balance. 
This will include those patients on 
intravenous tluids. tube feedings, with 
kidney failure and temperatures elevated 
to 102 degrees Fahrenheit or above: 

(N) catheter care; and 

(O) procedures used in caring for patients 
in the facility: 

(2) development of written job descriptions 
for nursing personnel: 

(3) periodic assessment of the nursing depart- 
ment with identification of personnel re- 
quirements as they relate to patient care 
needs and reporting same to the adminis- 
trator: 

(4) a planned orientation and continuing in- 
service education program for nursing 
employees and documentation of staff at- 
tendance and subject matter covered dur- 
ing inser\"ice education programs; 

(5) provision of appropriate reference materi- 
als for the nursing department, which in- 
cludes a Physician's Desk Reference or 
comparable drug reference, policy and 
procedure manual, and medical dictionarv' 
for each nursing station: and 

(6) estabhshment of operational procedures 
to assure that appropriate supplies and 
equipment are available to nursing staff 
as determined by indhidual patient care 
needs. 

Authority G.S. l3IE-~9: 42 U.S.C. 1396. 

.1912 M RSE ST.\FF1NG REQl IREMF.NTS 

(aj .A licensed facility shall provide licensed 
nursing personnel sutTicient to accomplish the 
foUo\\'ing: 

( 1 ) patient needs assessment, 

(2) patient care planning, and 

(3) super\'isor\' functions in accordance with 
the level of patient or resident care adver- 
tised or offered by the facility. 

The facility also shall pro\ide other nursing per- 
sonnel sutTicient to assure that at least acthities 
of daily living, personal grooming. restorati\e 
nursing actions and other health care needs as 
identified in each- patient s or residents plan of 
care are met. 

I b I A licensed multi-stoned facility (one having 
more than one stop,) shall pro\ide at least one 



person on duty on each patient care floor at all 
times. 

<-&+ A hospital V i ith elcilk'd nuroing C ' Or i icoo &hall 
pro' i ido total r . tatTing a^ required » R.uloo . h'^lQ. 
4-^44 aft4 tW+4 rf '^ S e ction. 

<-d4 A hocpital wiXh intermediate* ea» ocp i icoo 



L i hdU pro' i id e m addition i^ tbe director ef nuro 
ift&T at- leuL i t t*fte bceni ' ed practiced nur; . i> »«■ duty 
eight hour ' i p^* efevr oeven day - j pef ' . veek betv . een 
tbe hourf ' e4^ ^^^W a.m. aft4 ~i¥^ p.m. 44*e total 
number »f personnel te- patient ratiof . -. hall moot 
total staffrng requirement o contained m R.u1ol i 
r¥i^^ r¥X\\iii^ r4444 ef tte Section. 

(*->• A licenc e d nurr .e oh all ^ eft duty fef a4- 
miniotering aH medicationLi except fo* those 
medicatioii ' j a phycician ba^ ordered ift i i vnting te- 
br* adminiL ' tored by tbe patient, resident bf 
L ' Omeone other than a lic e n -' ed nur^ ^e aft4 obi ie p i ' 
iftg patient reaction te medications , recei' . ed. 

<4+ Tlii* number ef total peroomiol »» duty ia 
addition tr* the director ef nurving during a 
2 1 hour penod - jhall b^ a* l e ast 3r-= hours ef eafe 
pe* patient ^^^ fef i. killed nursing faciluie '' . -1-ri 
hours ©f eafe pe* patient day fof mtennediate 
eafe facilities. aft4 t^ hours ei^ eare peF resident 
tkiy fei^ domiciliary homer , a* indicat e d m tl*e 
charts contamed » Rules . I t J 13, .101 | rtft4 . 1 ' ) 1 5 
el Ai* Section. Tfee total Lillocaiion pr* 24 hours 
shall ftet be le^r? than uidicated eft charts con 
tainod i» R«k^ .H^Lv r¥i\A aft4 A^l\S ^ ^^^ 
Section, e xcept i» emergencies such a^ hazardous 
dn' i ing conditions ef epidemic illness among 
stalf. Ilov.e' i er. allocation ', ef personnel by e44ft 
must be e' . aluated by tfee director ef nur ' i . ing te 
assure that- patients' aft4 residents' h e alth, safety 
aft4 personal eafe needs afe met . AH exceptions 
te meeting minimum s . tatting requiremunts ■■ hall 
be reported t» ' . vriting te- tfee D e partment at- tfee 
eft4 ef each month. 

(-Si- AH- part tune staff shall meet personn e l aft4 
training requirements contained is- Rul e . 1 ^ 1 ^ ' ef 
tfeit. S e ction. 

f4^4 Pof purposes 6>f determining complianc e 
with tfte minimum staffing allov i able. aft eft^ 
ployee shall ' i vork only eiglit hours a Aetf wt order 
te- be counted a* meeting t4+e num e rical requir e 
ments indicated ift Rules . I'^i 1 3 . . b'i 1 1 aft4 , 1 1^ 1 5 
ef tfei* Section. Aft employee may be counted 
only fof tfee hours worked aft4 time actuiilly 
i . pent » e ach portion el a hospital ' . ' . ith nur ' ing 
home senices. (-err i - killed nur - ong. intemiediate 
care. domicihaP i' home portion^ ef the hospital. 

(ci Daily direct patient care nursing staff Ur 
censed and unlicensed, shall equal or exceed 2.1 
nursing hours per patient. (This is sometimes 
referred to as nursing hours per patient da\ or 
MlPPDor Ml PD ) 



962 



5:15 yORTH CAROLIXA REGISTER November 7, 1990 



PROPOSED RULES 



(1) The first shift shall equal or exceed .9 hour 
per patient. 

The second shift shall equal or exceed .!_ 
hour £er patient. 



(21 



The third shift shall equal or exceed A 
hours per patient. 
(4) A remaining balance of . 1 hour per patient 
is to be used flexibly to meet the variable 
needs of each facility on any shift . 
(d) Registered and licensed practical nurses 
shall provide daily nursing care of at least .52 
hour per patient. 

( 1 ) The first shift shall provide at least . 16 
hour per patient: 

(A) A registered nurse shall provide at least 
. 12 hour per patient on first shift. 

(B) The remaining .(14 hour per patient may 
be either an RN or LPN; 

(2) The second shift shall provide at least .15 
hour per patient. The requirements in 
Subparagraphs (d)(4) and (5) of this Rule 
shall be required even when higher than 
this minimum; 

(3) The third shift shall provide at least .15 
hour per patient. "I he requirements in 
Subparagraphs (d)(4) and (5) of this Rule 
shall be required even when higher th:m 
this minimum; 

(4) Inclusive in these figures is the require- 
ment that at least one licensed nurse is on 
duty for direct patient c^tre at all time; and 

(5) Nursing care shall include the services of 
a registered nurse for at least eight con- 
secutive hours a day, se\'en days a week. 
This coverage can be spread o\'er more 
than one shift if such a need exists. 



(e) Cach facility shall determine its minimum 
allowable shift and daily stafting hours by multi- 
plying the given NllPPl) or shift value by the 
appUcable census ligure. Nursing support per- 
sonnel including \yard clerks, secretaries, nurse 
educators and persons in primarih' administrative 
management positions and not activeh in\olved 
in direct patient care shall not be counted toward 
compliance with minimum daily requirements 
for direct care stafflng. 

(f) All exceptions to meeting minimum stalTing 
requirements shall be reported to the Department 
at the end of each month. Staffing waivers 
granted by the fed end go\emment for Medicare 
and Medicaid certitled beds shall be accepted for 
hcensure purposes. 

(g) "['he ratio of male to female nurse aides will 
be determined h\ the needs of the patients, par- 
ticularly the numbers of male patients requiring 
assistance with personal care. 

Authority G.S. I3IE-79: 42 U.S.C. 1396. 



.1913 SKILLKD NURSING CARE STAFFING 

REQLIREVIENTS (REPEALED) 
.1914 INTERMEDIATE NLRSING CARE 

STAFFING REQUIREMENTS (REPEALED) 

Statutory Authority G.S. I3IE-79. 

.1915 DOMICILIARY HOME PERSONNEL 
REQUIREMENTS 

(a) The administrator shall designate a person 
to be in charge of the domiciliary home residents 
at all times. The nurse in charge of ckiUod nurs- 
ing sen,'ices ef intormodiato eafe sgP i icos may also 
ser\'e as supervisor-in-charge of the domiciliary 
home beds. 

(b) If domiciliary home beds are located in a 
separate building or a separate level of the same 
buUding, there must be a person on duty in the 
domiciliary home areas at all times. 

(c) A licensed facility shall provide sufficient 
staff to assure that activities of daily living, per- 
sonal grooming, and assistance with eating are 
provided to each resident. Medication adminis- 
tration as indicated by each resident's condition 
or physician's orders shall be carried out as iden- 
tified in each resident's plan of care. 

(d) Domiciliary home services staffing require- 
ments, in addition to general requirements de- 
scnbed in Rules .1910, .1911 and .1912 of this 
Section, shall be as follows: 



First Shift 

One person 

to every 20 

or fewer 

residents 



Second Sliift 

One person 

to every 20 

or fewer 

residents 



Third Shift 

One person 

to every 50 

or fewer 

residents 



Statutory A uthority 
1396. 



G.S. I3IE-79: 42 U.S.C. 



.1916 REllABILIT.VnVE NURSING AND 
DECUBITUS CARE 

Each patient or resident shall be given care to 
prevent contractures, deformities, and decubiti, 
including but not limited to: 
(1) changing positions of bedfast and chairfast 
patients or residents every two hours and 
administering simple preventive care; doc- 
umentation of such care and outcome must 



5:15 NORTH CAROLINA REGISTER November I, 1990 



963 



PROPOSED RULES 



be included in routine summaries or 
progress notes; 

(2) maintaining proper alignment and joint 
movement to prevent contractures and 
deformities, which must be documented in 
routine summaries or progress notes; 

(3) implementing an individualized bowel and 
bladder training program except for patients 
or residents whose records are documented 
that such training is not effective: a monthly 
summary* for SNF patients and quarterly 
summaries for tGP- putionto aH4 domiciliary 
residents shall be written relative to each 
patient's or resident's performance in the 
bowel and bladder training program; and 

(4) such other services as necessary to meet the 
needs of the patient. 

Authority G.S. I3IE-79; 42 U.S.C. 1396. 

.1918 IRAIMNG 

(a) A hcenscd facility shall provide for all pa- 
tient or resident care employees a planned orien- 
tation and continuing education program 
emphasizing patient or resident assessment and 
planning, activities of daily living, personal 
grooming, rehabilitative nursing or restorative 
care, other patient or resident care policies and 
procedures, patients' rights, and staff perform- 
ance expectations. Attendance and subject mat- 
ter covered shall be documented for each session 
and available for licensure inspections. 

(b) The administrator shall assure that each 
employee is onented witliin the first week of 
employment to the facility's philosophy and 
goals. 

(c| Each employee shall have specific on-the- 
job traimng as necessary for the employee to 
properly peribnn his individual job assignment. 

(d) Unless otherwise prohibited, a nurse aide 
trainee may be employed to perioim the duties 
of a nurse aide for a penod of time not to exceed 
four months. Dunng this period of time the 
nurse aide trainee shall be pemiitted to peri'orm 
only those tasks for which minimum acceptable 
competence has been demonstrated and docu- 
mented on a skills check-off record. Job appli- 
cants for nurse aide positions who were fomierh 
qualified nurse aides but ha\'e not been gaintullv 
emplo\ ed as such for a penod ot^ 24 conseculne 
months or more shall be employed only as nurse 
aide trainees and must re-qualit\ as nurse aides 
\\ ithin tour months ot hire, 

Authority G.S. I3IE-79: 42 U.S.C. 1396. 

.1922 .VCriMllES .VM) RECKt.VllON 



(f) A hcensed facility shall display a monthly 
activities calendar which includes variety to ap- 
peal to different interest groups in the ckilliid 
nursing intcrmodiato care and domiciliary home 
services. 

Authority G.S. 131E-79; 42 U.S.C. 1396. 

.1926 NURSING HOME PATIENT OR 
RESIDENT RIGHTS 

(h) In matters of patient abuse, neglect or 
misappropnation the definitions shall have the 
meanings defined for abuse, neglect and exploi- 
tation respecti\elv as contained in the North 
Carolina FROllCTION UF THi; A R USED, 
MXH ECIED OR EXPI (JHFD DISABLED 
API Ur ACT, G.S. 108A-Q9 et seq. 

Authority G.S. I31E-79; 42 U.S.C. 1396. 

SI BCHAPTER 3H - Rl I.ES FOR THE 
LICENSING OF NFRSING HOMES 

SECTION .0100 - GENERAL INFORMATION 

.0107 TYPES OF FACILITIES (REPEALED) 

Statutory Authority G.S. I3IE-I04. 

.0108 DEFINITIONS 

The following definitions will apply throughout 
this Subchapter: 

(1) "Accident" means an unplanned or un- 
wanted event resulting in the injury or 
wounding, no matter how shght, of a patient 
or other indi\idual. 

(2) "Adecjuate" means, when apphed to vari- 
ous areas services, that the services are at 
least satisfactory in meeting a referred to 
need when measured against contemporary 
professional standards of practice. 

(3) "Administrator" means the person who 
has authority for and is responsible for the 
overall operation of a facUity. 

(4) ".Appropriate" means right for the specilied 
use or purpose, suitable or proper when 
used as an adjccti\-e. WTien used as a tran- 
sitive verb it means to set aside for some 
specified exclusive use. 

(5) "Capacity" means the ma.ximum number 
of patient or resident beds for which the fa- 
ciUty is licensed to maintain at any given 
time. This number shall be determined as 
follows: 

(a) Bedrooms shall have minimum square 
footage of 100 square feet for a single 
bedroom and 80 square feet per patient 
or resident in multi-bedded rooms. Tliis 
minimum square footage shall not include 



964 



5:15 NORTH CAROLINA REGISTER November I, 1990 



PROPOSED RULES 



space in toilet rooms, washrooms, closets, 
vestibules, corridors, and built-in furni- 
ture. 
(b) Dining, recreation and common use areas 
available shall total no less than 25 square 
feet per bed for skilled nursing aft4 intor 
mediate care beds and no less than 30 
square feet per bed for domiciliary home 
beds. 

(6) "Combination Facility" means afty nurring 
hom e iiconf i L'd to provide more than &fte 
les'el ef oaro. a combination home as de- 
fmed in G.S. 13 IE- 101. Tacilities listed in 
Rule .0107(3) through .0107(6) are combi- 
nation facilities. 

(7) "Commission" means the North Carolina 
Medical Care Commission unless otherwise 
specified. 

(8) "Convalescent Care" means care given for 
the purpose of assisting the patient or resi- 
dent to regain health or strength. 

(9) "Department" means the North Carolina 
Department of Human Resources. 

(10) "Director of Nursing" means the nurse 
who has authority and direct responsibility 
for all nursing services and nursing care. 

(11) "Drug" means substances: 

(a) recognized in the official United States 
Pharmacopoeia, official National 
Formulary, or any supplement to any of 
them; 

(b) intended for use in the diagnosis, cure, 
mitigation, treatment, or prevention of 
disease in man or other animals; 

(c) intended to affect the structure or any 
function of the body of man or other ani- 
mals, i.e., substances other than food; and 

(d) intended for use as a component of any 
article specified in (a), (b), or (c) of this 
Subparagraph; but does not include de- 
vices or their components, parts, or ac- 
cessories. 

(12) "Duly Licensed" means holding a current 
and valid license as required under the Gen- 
eral Statutes of North Carolina. 

(13) "Existing I-'acility" means a hcensed facil- 
ity; or a proposed facility, proposed addition 
to a licensed facility or proposed remodeled 
hcensed facility that will be built according 
to plans and specifications which have been 
approved by the , Department through the 
preUminaiy working drawings stage prior to 
the effective date of this Rule. 

(14) "Exit Conference" means the conference 
held at the end of a survey, inspection or 
investigation, but prior to fmalL7,ing the 
same, between the Department's represen- 
tatives who conducted the sur\'ey, inspection 



or investigation and the facihty adminis- 
tration representative. 

(15) "Incident" means an unplanned or un- 
wanted event which has not caused a wound 
or injury to any individual but which has the 
potential for such should the event be re- 
peated. 

(44) "Intermediate Care Facility (ICF)" means 
a facility ef portion thoroof, however named, 
which is ad' i 'ortiood, announced ©f main 
tiiined fof Ae express Bf implied purpose »f 
providing intermediate nuroing eafe e* 
convalesoont eafe fef thr a^ ©* more peroono 
unrelated to tbe Hcensee. 

f4^ "Intermediate Nursing" means tiw* \<i\a\ 
ef sen i 'ice si i hioh provides fef counseling, 
teaching, aft4 impl e m e nting proscribed 
treatment » aft intennediate safe facility. 
i* i* ministoruig ter assisting with a»4 main 
taining obs e nant continuous e*i* te- y*e 
chronioally ili i» a stable condition aft4 m- 
cludes administering medications; pro' i iding 
supporti\e afi4 restorative nursing proce 
dures to those ^vho eaft benefit from such 
senices; assisting with activities ©f daily !*¥- 
iftgf maintaining foley catheters, colostomies 
aft4 ileostomies; aft4 providing fof aft¥ other 
condition which requires the direction aft4 
supen'ision &f seP i 'ioes by a licensed physi 
cian afi4 provision ©f services by duly li- 
censed nursing personnel ©f by trained 
non licensed nursing personnel under t4ie 
super » ision ef a duly hcensed nurse. 

(-+S} ( 16) "Licensed Practical Nurse" means a 
nurse who is duly Hcensed as a practical 
nurse under G.S. 90, Article 9A. 

(4^ (17) "Licensee" means the person, firm, 
partnership, association, corporation or or- 
ganization to whom a hcense has been is- 
sued. 

f30> ( 18) "Life Care Center" means an institu- 
tion, firm, association, organization, corpo- 
ration, partnership, individual or other 
business which advertises to the public or 
provides continuing care to Lndi\iduals for 
life includmg retirement, domiciliary, inter 
mediate eafe ©f skilled and nursing care fa- 
cihties, from the time of admission to the 
time of death. Such continuing care is fur- 
nished pursuant to a continumg care agree- 
ment and to individuals not related by 
consanguinity or affinity to the provider. 

f34) ( 19) "Medication" means drug as defmed 
in (11) of this Rule. 

f^3} (20) "New Facihty" means a proposed fa- 
cihty, a proposed addition to an existing fa- 
cihty or a proposed remodeled portion of an 
e.xistmg facility that is constructed according 



5:15 P^ORTH CAROLINA REGISTER November I, 1990 



965 



PROPOSED RULES 



to plans and specifications appro\ed by the 
Department subsequent to the effective date 
of this Rule. If determined by the Depart- 
ment that more than half of an e>dsting fa- 
cility is remodeled, the entire existing facility 
shall be considered a new facility. 

f3^ (21) "Nurse .\ide" means any unliconL ' od 
malij e* fomalo poroon regardbf i O &f worliing 
t4tle omployod f^ a^ ' cignod m a facility fof ffe* 
purpo ' ' .i^ trf ai>;i: ' ting duly liconi ' ijd nurco i : ' 
with patient eafe e* providing patient eaje 
under tlw oupuP i ii ' ion m- direction ef duly 
licenced nuroe?. who is qualified to pro\ide 
nursing care under the super\'ision of a Ij^ 
censed nurse and is registered as a nurse aide 
in a nurse aide registrA' approved bv the De- 
partment. 

(22) "Nurse .Vide Trainee'' means an individual 



in training to becom 
(23) "Nursing Facilitv' 



a nurse aide. 



means that portion of 
a nursing home certified under Fide .XIX of 

in 



as 



the Social Secuntv .Act (Medicaid) 

compliance with federal program standards 
tor nursing facilities. It is often used as 
s\nonvmous with the term "nursing home" 



which IS the usual prerequisite lew'l of state 
licensure for nursing facilit\ i N F i certif- 
ication and Medicare skilled nursing faciUtv 
(SNFi certitlcation. 



(24) "Nurse in Charge" means the nurse to 
whom duties for a specified number of pa- 
tients and staff for a specified period of time 
have been delegated, such as for L'nit A on 
the 7-3 or 3-lfshit~t. 

(25) "On Duty" means personnel who are 
awake, dressed, responsive to patient needs 
and physically present in the facility per- 
forming assigned duties. 

(26) "Operator" means the owner of the nurs- 
ing home business. 

(27) ''Patient" means any person admitted for 
nursing care, to a skilled nun'ing e* inter 
mediate efw* tiicility. 

(28) "Pro\isional Ficense" means an amended 
license recognizmg signillcantly less than full 
comphance with the licensure rules. It is 
applicable to new licensees who are not yet 
fuUy operable under the licensee s control 
or to licensees with serious compliance 
problems. 

(29) "Physician" means a person licensed under 
G.S. Chapter 90. Article 1 to practice medi- 
cine in North Carolina. 

(30) "Qualitled Dietitian" means a person who 
meets the standards and qualification estab- 
lished by the Commission on Dietetic Reg- 
istration of the .American Dietetic 
.Association. 



(31) ''Registered Nurse" means a nurse who is 
dulv licensed as a registered nurse under G.S. 
90, '/Article 9A. 

(32) "Resident" means any person admitted for 
care to a domiciliar\' home part of a combi- 



nation home as defined in G.S. 1 3 1 E - 1 1 . 

(33) "Sitter" means an mdividual employed to 
provide companionship and social inter- 
action to a particular patient, usually on a 
private duty basis. 

(4^ "Skilled Nurr . ing" meang tl*at l e ^'el ef sef- 
viiri* wliich pro' r ide ' ' ' fof counc ' eling. teaching 
aft4 implementing pre -i cnbed treatment m a 
sldHed nursing facility, k i^ miniott-'ring t«T 
aosi ' . i ting V i ith aft4 maintaining ob 'i eP i ant 
continuous eaf^ te- tkt^ chronically ill ift a 
stable e* uu ' jtable condition. Such ' ler i ice 
includes administering all medicationo tft- 
oluding parent e ral medicationo aft4 
intra' i onou; . tluids: providing supportive aft4 
restorati' i e nursing procedures fef those pa- 
tients ' . vho eaft benel'it from such sep i icoo; 
maintaining aftv tubes mdwelling ift body 
cavitioc; administering oxygon ef othor 
medicinal gases »» a regular basis » aft- ««- 
stable condition: a^^ requiring duection »f 
supep i ision »f s e rvices l*y licensed physicians 
a«4 delivery" t4" senices 1*¥ licensed nursing 
personnel ef trained non licensed nursing 
personnel under tbe supervision 9ti a licensed 
nurse =4 hour ', pef day. 

(U44 "Skill e d Nur '. ing Facility (SNF)" means a 
facility ef a portion thereof howev e r nam e d, 
which » advertised, iinnounced ef main 
tained fof tkk^ express purpose ef providing 
sldlled nursing ef convalescent care fof three 
ef more persons unrelated te t4*e licensee. 
Tl+e pnmapy need ef (4fe pati e nts admitted 
i^ skill e d nursing ertfe eft a 2 I hour basio aft4 
continuing medical supervision. 

f44-^ "Suporsisor in Charge ( slcilled nursing)" 
means a duly licensed nurse te- V i hom ^-h- 
penisory duties have been delegated t*y t4%e 
Director ef ^ . ursing. 

(-4^ "Super . isor in Chiirge (inlennediate ettfe 
nursing)" means a duly licensed nurs e fof 
eigju hours {*ef 4ay between t4te hours ef 
7:00 am at^ Z-uu p.m. efr at- other times, a 
non liceii '^ ed employee te- whom duties , have 
been d e l e gat e d bv $4w Dir e ctor ef Nursing. 

(4?! (34) "Supervisor-in-Charge (domiciliary 
eafe facility home )" means any employee 
to whom super\'isory duties for the 
domiciliar>" home portion of a combination 
home facility have been delegated by either 
the Administrator or Director of Nursing. 

Auihority G.S. 13IE-I04; 42 L.S.C. 1396. 



966 



5:15 NORTH CAROLINA REGISTER November 1, 1990 



PROPOSED RULES 



SECTION .0300 - GENERAL STANDARDS OF 
ADMINISTRATION 

.0315 NURSING HOME PATIENT OR 
RESIDENT RIGHTS 

fh) In matters of patient abuse, nedect or 
misappropriation the detlnitions shall have the 
meaning defmed for abuse, neglect and exploita- 
tion respectively as contained in the North 
Carolina PROIHCHON OF U\\L ABLSHD. 
M-GI 1 dtp OR i:XPI on KD DlSABLl-D 
ADLl 1 ACT, G.S. 108A-9q et seq. 

Authority G.S. J3IE-I04; 1 31 E- 1 24; 1 31 E- 129; 
42 U.S.C. 1396. 



SECTION .0500 - NLRSING SERVICES 

.0505 NLRSING HEALTH CARE 

ADMINISTRATION AND SUPERVISION 

(a) A licensed facility shall have a Director of 
Nursing service who shaU be responsible for the 
overall organization and management of all 
nursing services in skilled nursing aft4 LntLirmodi 
ate ewe fuoilitio ' -i aft4 health care services in- the 
domicilicipy home portion trf combination fucili 
ties and shall be currently licensed to practice as 
a registered nurse by the North Carolina Board 
of Nursing in accordance with G.S. 90, Article 
9A. 

(b) The Director of Nursing shall not be 
counted as meeting the requirements for both the 
Director of Nursing and patient and resident care 
staffing contained in Rules .0506 and .0507 aft4 
tO^O* of this Section. 

(c) The Director of Nursing shall not serve as 
Administrator or Assistant Administrator. 

(d) A licensed facilitN', nuromg homo \\\\h: 

f44 L . lcillod nursing facilities or combination 
facilities with okillod nurning safe shall 
provide a fulltime Director of Nursing on 
duty at least eight hours per day, live days 
a week. A registered nurse shall relieve 
the Director of Nursing (be in charge of 
nursing) during the Director's absence; 

fi| froo ' . i tunding intL'nnL ' diuto eafe facilitic". ! ef 
combination int e nn e diat e caro 

domiciliary homci . ^. hall pro' . idc' a Diroc 
tef Bi Nur ' jing tnt duty h% tke facility at 
Icai i t four hour ' ,) pef wcuk. 1 ithor a li- 
conr i c'd practical nuroo Bf rogiotored nur ^.e 
'. hall be dc ' i . ignatcd at* m chargL* aw4 r . liall 

t'*it ■"v ■»•! / I 1 I f \ .' 1 ri i \-\ .-i « « 1 t , tT->-»-i ... 1 < . 1 f . t , • ■ 1 f. 1 1 • 1 , -1 I 1 f \ : 
TTf nr U tJt. T ITT rTTTT IMIVIIT T\. "J 1 L 1 1 \^ tTIT t I IIV- 1 Tt I ^ 

eight houni f>eF day, !. L" i \. ' n dayo pef week- 
bc ' t' i VL ' en the hourfl ef 14^ a.m. aH4 1-4^ 
p.m. At all timoi} ' ■ ' ■ hon th e re j* aft ab- 
oonco Bi a rogi ^. torod e* licon '. od practical 
nur ' jO, thc ' rc ' jhall be a pori i on » charge * t© 



whom dutioG have boon dologatod by tl*e 
Dirootor ©f Nursing. 

(e) A licensed facility shall employ and assign 
registered nurse, aft4 licensed practical nurses and 
non lio e nc i od staff nurse aides for duties in ac- 
cordance with G.S. 90, /Vrticle 9A. The Depart 
mont L . hall ref e r possibl e violations »f tl«* statute 
t© tke North Carolina Board »f Nursing fe* ifi- 
vostigation. 

(f) The Director of Nursing shall cause the 
following to be accomplished: 

(1) establishment and implementation of 
nursing policies and procedures which 
shall include but not be limited to the 
following: 

(A) assessment of and planning for patients' 
nursing care or health care needs and im- 
plementation of nursing/health care plans; 

(B) daily charting of any unusual occur- 
rences or acute episodes related to patient 
care, and progress notes written monthly 
tft SNFs aft4 quarterly in ICFs reporting 
each patient s performance in accordance 
with identified goals and objectives and 
each patient's progress toward 
rehabilitative nursing goals; 

(C) assurance of the delivery of nursing 
services in accordance with physicians' 
orders, nursing care plans and the facility's 
policies and procedures; 

(D) notification of emergency physicians 
or on-call physicians; 

(E) infection control to prevent cross- 
infection among patients and staff; 

(F) reporting of deaths; 

(G) emergency reporting of fire, patient or 
staff accidents or incidents, or other 
emergency situations; 

(H) use of protective devices or restraints 
to assure that each patient or resident is 
restrained in accordance with physician 
orders and the facility's policies, and that 
the restrained patient or resident is ap- 
propriately released and evaluated at a 
minimum of evcr>' 2 hours; 

(I) special skin care and decubiti care; 

(J) bowel and bladder training; 

(K) maintenance of proper body alignment 
and restorative nursing care; 

(L) super\ision of and assisting patients 
with feeding: 

(M) intake and output observation and re- 
porting for those patients whose condition 
warrants monitonng of their fluid balance. 
This will include those patients on 
intravenous fluids, tube feedings, with 
kidney failure and temperatures elevated 
to 102^F. or above; 



5:15 NORTH CAROLINA REGISTER November I, 1990 



967 



PROPOSED RULES 



(N) catheter care; and 

(O) procedures used in caring for patients 
in the facility; 

(2) development of written job descriptions 
for nursing personnel; 

(3) periodic assessment of the nursing De- 
partment with identification of personnel 
requirements as they relate to patient care 
needs and reporting same to the Admin- 
istrator; 

(4) a planned orientation and continuing in- 
service education program for nursing 
employees and documentation of staff at- 
tendance and subject matter covered dur- 
ing inservice education programs; 

(5) obtainment and provision of appropriate 
reference materials for the nursing De- 
partment, which include a Physician's 
Desk Reference or comparable drug ref- 
erence, policy and procedure manual, and 
medical dictionary' for each nursing sta- 
tion; and 

(6) establishment of operational procedures 
to assure that appropriate supplies and 
equipment are available to nursing staff 
as determined by individual patient care 
needs. 

Authority G.S. 13IE-I04: 42 U.S.C. 1396. 

.0507 M KSE STAl I IN(; Rh QLIREMEMS 

(a) .A licensed facility shall provide licensed 
nursing personnel sufficient to accomplish the 
following: 

(1) patient needs assessment, 

(2) patient care planning, and 

(3) supervisor\' functions in accordance with 
the le\els of patient or resident care ad- 
vertised or offered by the facility. 

The facility also shall provide other nursing per- 
sonnel sufficient to assure that at least activities 
of daily li\'ing, personal grooming, restorative 
nursing actions and other health care needs as 
identified in each patient's or resident's plan of 
care are met. 

(b) A licensed multi-storied facility (one ha\ing 
more than one stor\') shall provide at least one 
person on duty on each patient care tloor at all 
times. 

(c) A ;' ldllL ' d n urging facility vhall proside total 
r ' taffing et^ riKiuircil i+i I'vuk" . . il .^O.^. O.^Od w+tl 
.1)51 I Sj e4' At^ .Soction. DaiK direct patient care 
nursinu statf licensed and unlicensed, -'hall equal 
or exceed 2. 1 nurMiiL: hmirs per patient. ( 1 his is 
sometimes referred \o_ as nursing hours per pa- 
tient day or Mll'PD or Ml PP.) 

( 1) 1 he first shitt shall equal or exceed .Q hour 
per patient. 



(2) The second shift shall equal or exceed n_ 
hour per patient. 

(3) The third shift shall equal or exceed A 
hours per patient. 

(4) .'\ remaining balance of . 1 hour per patient 
is to be used flexibly to meet the variable 
needs of each facility on any shift. 



(d) Aft intormodiatij eaf(» facility ; . hall prosidia ift 
addition te t4%e Director ef Nurr . ing, at- l e ant e«<* 
licL'ni; i ed practical nurno »ft duly L ' ight hourii pef 
davr so\ jn dayo pef ' . veek botv i oon t4^ hours ©f 

^^^tTT CI > 1 j t ■ rtTiTT "'^^TTT t^^T^^ ^P^T^? TT^TTtT rTTTTTTT*T?r tTT 

p e r ' joniiL^l to- pationt ration shall moot total otaff 
iftg roquiromonto contained m P».uloo .0505, .U.^06 
aft4 .0509 t*f tfe Soction. Registered and ]> 
censed practical nurses shall pro\'idc daily nursing 
care of at least .52 hour per patient. 

( 1) The first shift sh:dl provide at least .16 
liour per patient. 
(■■\) A registered nurse shall provide at least 
. 12 hour per patient on first shift. This 
registered nurse shall not be the director 
of nursing. It must be a direct patient care 



(B) The remaining .04 hour per patient may 
be either an RN or LPN; 



Ql 



(3) 



(il 



121 



The second shift shall pro\'ide at least . 15 
hour per patient. ['he requirements m 
Subparagraphs (di(4) and (5) of this Rule 
shall be required e\'en when higher than 
this minimum: 

The third shift shall pro\ide at least . 15 
hour per patient. Ihc requirements in 
Subparagraphs (d)(4) and ( 5) of this Rule 
shall be required even when higher than 
this minimum: 

Inclusi\'e in these figures is tfie require- 
ment that at least one licensed nurse is on 
dut\ for direct patient care al aU times; 
and 

Nursing care shall include the ser\ices of 
a registered nurse tor at least eight con- 



secutive hours a day. se\en days a week. 
This co\erage can be spread o\'er more 
than one shitt if such a need exists. 
(e) A licen -. t- ' d nur^ e ■■ hall b<* oft duty ft+f *d- 
mini '' l e ring rttt inedicationL i rtft4 ob 'i or i ing pLitiont 
reaction to medication; , rocoisod. e.xcopt ft*f those 
modicatioiTj a physician few orderod » wnting to 
be adminivtered b^ Ae patijnt. r e sident ef 
someone oih e r than a- lic e nced nur '.e , 1 ach fa- 
cility shall iletennine its minimum allowable shift 
and daiK" stalfing hours b\" multiphing the gi\en 
Nl IPPI) or shitt \alue bv th£ applicable census 
figure. Nursing support perstmnel incluiling 
ward clerks, secrelanes. nurse educators and per 



sons m pnmanh adminislratne management 
positicms and not acti\elv in\ohed in direct pa- 



96S 



5:15 iWRTH CAROLINA REGISTER November I, 1990 



PROPOSED RULES 



tient care shall not be counted toward compli- 
ance with minimum daily requirements for direct 
care staffmg. 

(f) ?4%e numbor ef total poroonnol e» duty m 
addition to the Dirootor ef Nurr . ing during a 
2 ' 1 hour poriod ohall be at loast 3r4 houro ef 6ai=» 
pef pati e nt day fof Gldllod nuroing faciliti e o, 4-r8 
houro ef Gate pef patient day fe* intormodiato 
eafe faoilitioo, m^ t^ houro »f safe pef rooidont 
day fof domiciliary homoo. as indicated i» tfe» 
ebafte contained tft fe^les .0508, S^m aad tO^-W 
&^ tfe» Section. Tbe total allocation f>eF ^ hours 
shall He* be lese than indicated ©«■ charts con 
taified » R«k« T©^^ rO^Oa aftd ^4^4^ &f A» 
Section, except m emergencies such a* hazardous 
driving conditions ©f epidemic illn e ss among 
staff. 1 lo' . ' i over, allocations »f personnel by sbift 
must be e' l aluatod by tbe Director ef Nuroing te 
aosuro tbat- patients' afid residents' health, oafety 
stPi^ personal safe needs are met. AH- exceptiono 
to mooting minimum staffmg requirements ohall 
be report e d ift writing te- the Department at- ti^e 
eftd ©f e ach month. All exceptions to meeting 
minimum staffmg requirements shall he reported 
to the Department at the end of each month. 
Staffing wai\ers granted bv the federal go\'em- 
ment for Medicare and Medicaid certified beds 
shall be accepted for licensure purposes. 

fg) AH parttime '. tolf shall meet personnel a«4 
training requiremento contamed h* Rule .0513 ef 
tbi* Section. 

(fe^ f-^f- purpooeo ef detennining compliance 
with t4*e minimum otaffing allov . able, b© e^s- 
ployee worldng only oiglit hours a day ohall be 
counted as meeting tbe numerical requiremento 
indicated m fedes mi^ tO^W aftd t4^W ef tbis 
Section »» any tw» conoecutiv e shifts e* eft- twe 
ef more levels ef c - ar e . Aft employee 9Pti^ be 
counted only fef fbe hours worked aftd tim e ae- 
tually spent » e ach portion ef a nursing home. 
ir^ skilled nursing, intermediate car e . domiciliaPr 
homo portion(s) ef tbe nursing home. 

(i) (£} The ratio of male to female nurse aides 
win be determined by the needs of the patients, 
particularly the numbers of male patients requir- 
ing assistance with personal care. 

Authority G.S. I3IE-104; 42 L.S.C. 1396. 

.0508 SKILLED NLRSING CARE STAFFING 
REQl IREMEMS (REPEALED) 

.0509 INTERMEDIATE NLRSING C.VRE 
STAFFING REQUIREMENTS 
(REPEALED) 

Statutory Authority G.S. I3IE-I04. 

.0510 DOMICILIARY HOME PERSONNEL 
REQUIREMENTS 



(a) The Administrator shall desigjiate a person 
to be in charge of the domiciliary home residents 
at all times. The nurse in charge of the sldllod 
nursing facility ef intermediate eape facility may 
also serve as superv'isor-in-charge of the 
domiciliary home or beds. 

(b) If domiciliary home beds are located in a 
separate building or a separate level of the same 
building, there must be a person on duty in the 
domiciliary home at all times. 

(c) A licensed facility shall provide sufficient 
staff to assure that activities of daily living, per- 
sonal grooming, and assistance with eating are 
provided to each resident. Medication adminis- 
tration as indicated by each resident's condition 
or physician's orders shall be carried out as iden- 
tified in each resident's plan of care. 

(d) Domiciliary homo staffing requiremento, ift 
addition to general requiremento described ift 
fades m^ mm aRd .4»a;^ eftfe Section, sbaH 
be as follows: 



Qfie person 

te e ver> ' 54^ 

rosidento 



S e cond Shift 

Qfte person 

te every M 

residents 



TbifdSbift 

Q«e person 
te evefy -SO 

residents 

Domiciliar^• home facilities (Home for the Aged 
beds) licensed as a part of a combination nursing 
home shall complv with the staffing requirements 
of JO NCAC 42D .1407 as adopted bv t_he Social 
Services Commission for freestanding domiciliary' 
homes. 

Authority G.S. 1 31 E- 104; 42 U.S.C. 1396. 

.051 1 REIIABILIT.\TIVE NLRSING .AND 
DECl BITLS CARE 

Each patient or resident shall be given care to 
prevent contractures, deformities, and dccubiti. 
including but not limited to: 

(1) changing positions of bedfast and chairfast 
patients or residents every two hours and 
administering simple preventive care: Doc- 
umentation of such care and outcome must 
be included in routine summaries or 
progress notes; 

(2) maintaining proper aligrmient and joint 
movement to pre\ent contractures and 



5:15 NORTH CAROLINA REGISTER November L 1990 



969 



PROPOSED RULES 



dcfonnitics, which must be documented in 
routine summaries or progress notes; 
(3) implementing an individualized bowel and 
bladder training program except for patients 
or residents whose records are documented 
that such training is not effective; A 
monthly summary for SNF patients and 
quartorly f i ummaries fof tGP patients aft4 
domiciliary residents shall be written relative 
to each patient's or resident's pertbrmance 
in the bowel and bladder training program. 

Authority G.S. 13IE-I04: 42 U.S.C. I3Q6. 

SECTION .0700 - PHYSICIAN SERMCF.S 

.0709 DOCUMENTATION 

Physicians shall maintain appropriate clinical 
records as required of the physician in Rule .0609 
of this Subchapter, including documentation of 
a physician visit to the patient by progress notes 
written at least every 90 days Ht » -s kill e d nun . mg 
facility ftft4 l^ i ltv 444> days ift a« mtonn e diat c* erW* 
facility and a discharge summary which includes 
the patient's or resident's prognosis, fmal diag- 
nosis or cause of death. 

Authority G.S. I3IE-I04; 42 U.S.C. 1396. 

.0711 BRAIN INJURY REHABILITATION 

In nursing homes with designated brain injury 
extended care units the attending physician re- 
sponsible for a patient's care and rehabilitation 
program shall have specialized training or interest 
in rehabilitation. The intensity of the program 
requires that there shall be direct patient contact 
by a physician at least once per week and more 
often as the patient's condition warr;mts. Each 
patient's multi-discipline rehabilitation program 
shall be developed and implemented under the 
supervision of the attendmg physician. 1 he at- 
tending physician shall actively participate in in- 
dividual case conferences or care plamiing 
sessions and shall complete and sign discharge 
summaries and records within 1 5 days of patient 
discharge. When patients arc to be discharged to 
either another health care facility or a residential 
setting the attending physician shall assure that 
the patient has been provided with a discharge 
plan which mcorporates optimum utilization of 
community resources and post discharge conti- 
nuity of ccu'e and services. 

Statutory Authority G.S. I3IE-I04. 

SECriON .1 100 - SPECIALIZED 

REHABILITATE E AND IIABILIT.\T1\ E 

SERMCES 



.1107 \ENTIL.VTOR DEPENDENCE 

Patients requiring the use of ventilators for more 
than 20 hours a day have respiratory needs re- 
quiring the immediate availability of airway 
maintenance and cardiopulmonary resuscitation 
(CPR). Such ventilator dependent patients shall 
be arranged in units which shall meet the fol- 
lowing special requirements: 

( 1 ) A ventilator dependent unit shall be served 
by a single nursing station. Rooms desig- 
nated for use by ventilator dependent pa- 
tients shall be equipped with electrical 
receptacles on a system with an emergency 
power source. Oxygen to each patient's 
room shall be provided through a central 
fixed installation system. 

(2) Each unit shall be equipped with one full 
reclining wheelchair for each patient. There 
shall be a spare ventilator ready for emer- 
gency use 24 hours a day. Whenever the 
spare is placed in service it shall be replaced 
by another backup ventilator within 12 
hours. 

(3) Respiratory therapy services shall be pro- 
vided 24 hours a day and shall be under the 
supervision of a respiratory therapist who, 
at a minimum has received an associate de- 
gree in respiratory therapy from a program 
accredited by the American Medical Associ- 
ation, has at least one year of clinical expe- 
rience in respiratory therapy and is eligible 
for registp.' as a therapist with the National 
Association of Respiratory Care. The ser- 
vices of a respiratory' therapist shall be em- 
ployed in the facility in a ratio of two hours 
per week per %entilator dependent patient 
with a minimum of 20 hours per week for 
one to ten patients. In the absence of the 
respiratory therapist, required respiratory 
therapy shall be provided by a respiratory 
therapy technician who has completed a 
qualiiying one year AMA appros'ed course 
or a registered nurse aide or other licensed 
nursing personnel who have been both ap- 
proved as specially trained by the respiratory 
therapist and ha\'e the respiratory therapist 
on call. Wlicn there are more than 20 pa- 
tients respiratory therapy services shall be 
increased at least 1.2 hours per patient day. 
The responsibilities of the respirator}' thera- 
pist shall include: 

(a) Administering breathing treatments such 
as intermittent positive pressure breathing, 
incentive spirometr,', and aerosol treat- 
ments. 

(b) Coi"mecting patients to continuous 
ventilators, adjusting gas levels as directed 



9^0 



5:15 NORTH CAROLINA REGISTER November I, 1990 



PROPOSED RULES 



by a physician and reporting results to the 
physician. 

(c) Disassembling, cleaning, repair and reas- 
sembling of all humidity, oxygen and 
ventilation equipment. 

(d) Participation in interdisciplinary team 
conferences. 

(e) Reviewing or validating respiratory clinical 
notes. 

(4) Prior to being assigned any direct nursing 
care duties nursing personnel must be 
trained and competent in the following 
areas: 

(a) knowledge of respiratory anatomy, physi- 
ology; 

(b) emergency equipment operation, alarm 
functions, airway maintenance and general 
emergency procedures; 

(c) maintenance and trouble shooting of re- 
spirator>' equipment; 

(d) maintenance of medical records; 

(e) CPR certification; and 

(f) documentation of equipment maintenance. 

(5) Direct nursing care staffmg shall be in ac- 
cordance with Rule .1109 of this Section. 

Statutory Authority G.S. I3IE-I04. 

.1108 BRAIN INJIRV EXTKNDED C.\RE 

Brain injury extended care is a multi-discipline 
intensive rehabilitative program for patients who 
have incurred brain damage caused by external 
physical trauma and who have completed a pri- 
mary course of rehabilitative treatment, are at 
least one year post trauma, and have reached a 
point of no gain or progress for more than three 
consecutive months. Ser\'ices are provided 
through a medically supervised interdisciplinary 
process and are directed toward restoring the in- 
dividual to the optimal level of physical, 
congnitive and behavioral functioning. 

( 1 ) Overall supervisory responsibility for brain 
injury extended care services shall be as- 
signed to a registered nurse with one year 
experience. 

(2) Required clinical services, in addition to 
medicine and nursing, shall be physical 
therapy, occupational therapy, nutrition, 
and social work. Minimum requirements 
for each of the required additional clinical 
areas are as follows: 

(a) Physical Therapy shall be provided by a 
physical therapist with a current valid 
North Carolma license working in the 
brain injur}' unit a minimum of 20 hours 
per week plus an additional two hours per 
week for each patient in excess of ten. 
(e.g.: 20 patients = 40 hours per week) 



The assistance of a physical therapy as- 
sistant or aide shall be provided at the rate 
of two hours per week per active physical 
therapy patient on a facility wide basis 
with a minimum of 40 hours per week 
regardless of how small the census. 

(b) Occupational therapy shall be provided 
by an occupational therapist with a cur- 
rent valid North Carolina License working 
in the unit 20 hours per week plus an ad- 
ditional two hours per week for each pa- 
tient in excess of ten. (e.g.: 20 patients 
= 40 hours per week) The assistance of 
an occupational therapy aide or assistant 
shall be provided at the rate of two hours 
per week per patient with a minimum of 
one full time aide. 

(c) Clinical nutrition services shall be provided 
by a qualified dietician with two years 
clinical training and experience in nutri- 
tion. Clinical nutrition services shall in- 
clude: 

(i) Assessing the appropriateness of the or- 
dered diet for conformance with each pa- 
tient's physiological and phannacological 
condition. 

(ii) Evaluate each patient's laboratory data 
in relation to nutritional status and hy- 
dration. 

(iii) Apply technical knowledge of feeding 
tubes, pumps and equipment to each pa- 
tient's specialized needs. 

(d) Clinical Social Work shall be provided by 
a clinician holding a Master s degree in 
Social Work (MSW) and certified by the 
Academy of Certified Social Workers 
(ACSW). 

(3) Optional clinical services to be provided on 
a case by case basis as prescribed or ordered 
shall include recreation therapy, respiratory 
therapy and speech pathology. Minimum 
requirements for each of these disciplines are 
as follows: 

(a) Recreation therapy, when required, shall 
be pro\ ided by a cHnician eligible for cer- 
tification as a therapeutic recreation spe- 
cialist by the State Board of Therapeutic 
Recreation Certification. In event that a 
qualified specialist is not locally available, 
alternate treatment modalities shall be de- 
veloped by the occupational therapist and 
reviewed by the attending physician. 

(b) Speech therapy, when required, shall be 
provided by a clinician with a current 
valid license in speech pathology issued 
by the State Board of Audiology and 
Speech pathology. 



5:15 NORTH CAROLINA REGISTER November I, 1990 



971 



PROPOSED RULES 



(c) Respirator*' therapy, when required, shall 
be pro\'ided by an individual meeting the 
same qualifications for providing respir- 
atory therapy under Rule .1107 of this 
Section. 

(4) Each patient's rehabilitation program shall 
be governed by a multi-discipline treatment 
plan incorporating and expanding upon the 
health plan required under Section .0400 of 
this Subchapter. The plan is to be initiated 
on the first day of admission. Upon com- 
pletion of basehne data development and an 
integrated interdisciplinary assessment the 
initial treatment plan is to be expanded and 
finalized within 14 days of admission. 
Through an interdisciplinar\' process the 
treatment plan shall be reviewed at least 
monthly and revised as appropriate. In ex- 
ecuting the treatment plan the interdiscipli- 
nary team shall be the major 
decision-making body and shall determine 
the goals, process, and time frames for ac- 
compUslmient of each patient's program. 
Disciplines to be represented on the team 
shall be medicine, nursing, clinical pharmacy 
and ;dl other disciplines directly in\'olved in 
the patient's treatment or treatment plan. 

(5) Each patient's overall rehabilitation pro- 
gram shall be assigned to an individually 
designated program manager. The program 
manager shall be responsible for: 

(a) coordmating the development, implemen- 
tation and periodic review of the patient s 
treatment plan: 

(b) preparing a monthly summar\' of the pa- 
tient's progress: 

(c) culti\'ating the patient's participation m the 

program: 

(d) general supervision of the patient during 
the course of treatment; 

(e) evaluating appropriateness of the treat- 
ment plan in relation to the attainment of 
stated goals: and 

(f) assuring that discharge decisions and ar- 
rangements for post discharge follow-up 
are properly made. 

(6) For each 20 patients or fraction thereof 
dedicated treatment facilities and equipment 
shall be provided as follows: 

(a) A speech therapy room with dimensions 
which equal or exceed 175 square feet and 
which is so designed and maintained as to 
permit free movement of tlu"ee fully 
opened reclming wheelchairs. 

(b) Two occupational physical therapy 
rooms, each with dimensions which equal 
or exceed 600 squ:ire feet. Each room 
shall be equipped with three double size 



(c) 
(d) 



(e) 



mat tables, one tilt table, and one set of 
free standing or foldaway parallel bars. 
Each room is to be plumbed with a sink 
suitable for hand washing. Each room 
shall open directly to a wheelchair acces- 
sible water closet. 

One full reclining wheelchair per patient. 
Special physical therapy and occupational 
therapy equipment for use in fabricating 
positioning de\ices for beds and wheel- 
chairs including splints, casts, cushions, 
wedges, and bolsters. 

There shall be roll in bath facilities with a 
dressing area available to all patients and 
which shall afford maximum privacy to 
the patient. 



Statutory Authority G.S. I3IE-I04. 

.1109 SPFXI.AI. NLRSING RF.Ql IRF.MF.NTS 

Direct care nursing personnel staffmg ratios es- 
tablished in Section .0500 of this Subchapter 
shall not be applied to nursing services for pa- 
tients who are either ventilator dependent or re- 
quire brain injur.' extended care. WTien such 
senices are provided the table in this Rule es- 
tablishes the minimum acceptable direct care 
nursing staff ratios per patient. It is also required 
that regardless of how low the patient census the 
direct care nursing staff shall not fall below a 
registered nurse and a nurse aide I at any time 
during a 24 hour period. The minimum direct 
care nursing staff ratios are: 



STAFF 
POSITION 

RN 

LPS 

NA I 

N.-\ (Trainee) 

STAFF 
POSIFION 

RN 
LPN 
NA I 

N.\ (Trainee) 



1st SHIFT 
STAFF R.-\TIO 

.8 NH P 
.8 NH P 

.75 NH P 




2nd SHIFT 
STAFF R.\T10 

.4 NH P 
.8 NH P 
.75 NH P 




3rd SHIFT DAILY 

STAFF R_ATIO RFQL IRE.MENTS 



.4 NH 
.4 NH 
.4 NH 







1.6 NH P 

2.0 NH P 

1.9 NH P 




Statuton- Authoritv G.S. 13IE-I04. 



SECTION .1500 - DESIGN AND 
CONSTRLCriON 

.1501 GENER.AL RLLES 

(d) The domiciliar>' home portion of a combi- 
nation facility must meet the rules t4" ^^ ' killt ' d 
for a nursing aft4 tin* intL'nnL'duitL' ea*^ facility 
contained in Sections .1500, .1600, .1700 and 



972 



5:15 NORTH CAROLINA REGISTER November 1, 1990 



PROPOSED RULES 



.1800 of this Subchapter, except when separated 
by a two-hour fire resistive construction. In this 
case, the domiciliar\' home portion must meet 
the rules for domiciliary homes, 10 NCAC 42D, 
and supporting areas must be located in the same 
area of the facility as the domiciliary home por- 
tion. 

Authority G.S. I31E-I04: 42 U.S.C. J396. 



ing. Room 20/ , 70/ Barbour Drive, Raleigh, North 
Carolina 27603. 



Co 



'Omment Procedures: Written comments con- 
cerning the rules should be submitted as soon as 
possible but no later than December /7 , /990 to 
Lynda McDaniel, 701 Barbour Drive, Raleigh, 
North Carolina 27603. Oral comments may be 
presented at tfte hearing. 



SECTION .1600 - Fl NCTIONAL 
RFQl IRKMKNTS 

.1612 REQLIRED SPACES 

(b) The total space set aside for dining, recre- 
ation and other common uses shall not be less 
than 25 square feet per bed for a S N F afi4 aft 
t&P nursing facility and 30 square feet per bed 
for a domicili;iry home. Physical therapy and 
occupational therapy space shall not be included 
in this total: 

(1) In new nursing homes diversional activity 
and therapeutic recreation areas shall be 
provided separate from the main Living 
and dining areas. 

(2) Dining, recreation and other common use 
areas shall be designed and equipped to 
provide accessibility to both wheel chair 
and ambulatory patients. 

(3) Recreation and other common use areas 
shall be designed for independent and 
group activity use. 

(4) Closets and other storage areas for equip- 
ment and supplies shall not be included in 
the required dining, recreation and com- 
mon use floor space area. 

(5) Handicap accessible outdoor areas for in- 
dividual and group activities shall be pro- 
vided. 

Authority G.S. /3/E-/04: 42 U.S.C. 1396. 

•k'k-k-k-k'k-k'k'k-k-k-k'k'k'k-k^-k 



No 



otice is hereby given in accordance with G.S. 
/50B-/2 that the Certificate of Need Section. Di- 
vision of Facility Services, Department of Human 
Resources intends to amend nde(s) cited as /O 
NCAC 3R .03/7. .///3. .1/15 - .1/20 and adopt 
3R .//24. 

1 he proposed effective date of this action is 
March /, 1991. 

1 he public hearing will be conducted at 3:00 
p.m. on December 17, 1990 at the Council Build- 



SUBCHAPTER 3R - CERTIFICATE OF NEED 
REGLL.VriONS 

SECTION .0300 - APPLICATION AND REVIEW 

PROCESS 

.0317 WrniDR.WVAL OF A CERTIFICATE 

(i) In direct response to the 1987 Omnibus 
Budget Reconciliation Act's replacement of the 
terms "skilled nursing facility" and "intenncdiate 
care facility" with "nursing facility" for use by 
■Medicaid certified nursing facilities, the CON 
Section will not withdraw a certificate of need if 
the holder of the certificate de\ek)ps or operates 
a nursing facrlity without designating its nursing 
facility beds as cither skilled nursing facility beds 
and or intermediate c:ire facilit\ beds. In all 



other respects, the holder of the certificate shall 
develop and operate the facility in inatenal com- 
pliance with representations made in the CON 
application and an\ conditions placed on the 
certiticate by the Department. 

Statutory Authority G.S. /3/E-/77; /3/E-/S9. 

SECTION .1 100 - { RITERIA AND STANDARDS 
FOR NLRSING FACILITY SERVICES 

.1113 DEFINinONS 

The definitions in this Rule will apply to all 
rules in this Section: 
(1) A nursing h«ffH* facility means a health care 
facility as defined in GJv 131i:-101(6). e4- 
fering nur^ . ing cure, mudical car e , aft4 {*ef^ 
conol ettfe • jur i icoa te p e r -i ons ' . sho, l*v 
rcuiion ef illnoM i . inlimiity t-vf adscincod »w 
ttff unabk ' tt> ettfe ft+f thoni 'i L'Keii a«4 Vrkn* 
hiiVL ' liL ' allh probk ' in ' .' . which rangL * from 
minimal te- sx ' ry ^ . L ' ruiu ' j. A44 nuri i ing honikHi 
prosido L i killcd nuning eaw »f intennL - diate ' 
ettfe e* a combination wf t+n* t-vn-vr I hL" . o 
Il'vl'I; . t4' t?«ft» tr+ft bt* further dt - fiiit ' d rt^ M- 
low '. : 
fa| "Skilk'd nurt . iiig tn+fe i . ^rvicoi . " moan '. «*fe 
rcndLTod ift a facility ef paft ei » facility 
liCL'n '. L>d undor 'i tatL ' law- to jirosido mining 
' . i lm' i icL"j W> patiL ' nt '. requiring r . uch '. onici." ' . 
The facility rendering ;. kilk ' d nursing ser- 
vices must: 



5:15 NORTH CAROLINA REGISTER November I, 1990 



973 



PROPOSED RULES 



(+^ (a2 have a physician, a registered nurse 
or a medical stalT responsible for the exe- 
cution of policies; 

fii) rb| maintain climcc'd records on all pa- 
tients: 

fi«4 (c| provide 24-hour nursing service, via 
registered nurses and licensed practical 
nurses, to the patients who require cldllod 
nursing care; 

(+V-)' (_d| employ at least one registered nurse 
full time; 

fv-} (e} maintain a utiliy.ation review plan. 
ft4 intonnodiatL' &*» i i onicor i " moanr . ertfe 
rondLTL'd H* » facility e* f«ft- ef a facility 
licL ' n^L ' d undL'r [ . tutu k*w to pro iJ>3 
health rL ' lati^d ertw »ft4 coP i iceo te- mdi 
vidualn who de- ft©4- roquire A# dogro e ef 
eafe aft4 treatm e nt ' ■ ' ■ hich a hof i pitcd &f 
L . killL ' d nur '' ing facility i* dc^Mgnt'd te- f»fe- 
\ id e !*«*■ ' . i i ho. bL'CQU '. o t-4" thcnr montal ef 
physical condition. rL'quire eaft* a«4 -rt^^ 
vicoo abo' i 'Q Ae lev e l ef room aft4 board. 
34*1^ facility mur . t providL * nursing care, v+a 
e+h? rogi '. lLTL'd nur^L' b+ h+^ licon '. L'd prac 
(+t^ nur -.e . evH- each day ' . . hjlt . 
(-3-> "Nur^ . ing honu ' i . L ' nicec" niLHino aftv ef Ae 

sop i ici? ' " . dofinod i» t4*» Rule. 

(2) "Brain iniur\' extended care" is defined as 
a multi-discipline inlcnsi\'e rcliabilitative 
proiiram tor patients who ha\c incurred 
brain damage caused bv external pin sical 
trauma and who ha\'e completed a pnmar\' 
course of rehabilitatne treatment, are at_ least 
one \'ear post trauma and ha\e reached a 
point ot no gain or progress for more than 
three consecutne months. Services are 
pro\ ided through a medicalh' supervised 
interdisciplinar\' process and are directed to- 
ward restonng the mdnidual to the optimal 
le\el ot ph\ sical. cogniti\-e and beha\ioral 
tunctioning. 

(3) "\'entilator dependence" means patients 
who require the use iA \'entilators for more 
than 20 hcuirs a da\ and ha\ e respirator\" 
needs requinng the immediate a\'ailabilitv 
of ain\a\- maintenance and cardlopulmonar^^ 
resuscitation (C'I'R). 

Statuiofj Authority G.S. I5IE-177( 1 ). 

.1115 ( VPACn \ IN IHK FACn IT^ AM) 
IN THE IIF.ALllI SKRMCF, .\KKA 

(a) Proposals filed b) or on behatf of nursing 
facilities fof nurr . ing homo ' jonicor . must be con- 
sistent with the North Carolina State .Medical 
Facilities Plan. 

(b) A proposal to pro\ide new or expanded 
nursing ftcilitv ■ ikillcd nur - . ' ing ea» e* intennedi 



ate Gafe services must specify the numbers of 
nursing facilit\' skilled nursing afi4 intermediate 
eafe beds to be operated following the com- 
pletion of the proposed project. 

(c) A proposal to provide new nursing facility 
[ . killed nuri i mg eafe beds shall not be approved 
unless the average occupancy, over the nine 
months immediately preceding the submittal of 
the proposal, of the total number of functional 
nursing facilitv ^ ' killed nurring beds within the 
facility in vshich the new beds are to be operated 
is at least 90 percent. 

f4^ A propof . al to provide ftew intennediate 
eaw bed 'i shtdl B+*t- t=n* appro' i ed unle '. r . tlw a' t or 
age occupancy, o' l er tfei* H+t+e month - ) imm e 
diately preceding At* iiubinittcd (-4 t4*e propo 'i al. 
Bi tbe total number »f functional intennediate 
eafe bed?: ; v . ithin t4+e facility i» v . hich tl+e fww 
bed ' .' i af# to br* operated t^ at leai . t W percent. 

(-e^ (d) A proposal to con\'ert existing licensed 
domiciliary beds to nursing facilitv beds skilled 
nursing safe e* intermediate eafe seP i ices must 
demonstrate that the proponent has adequately 
planned for the relocation or displacement of ex- 
isting domiciliars' residents. .Additionally such 
relocation or displacement must not result in ex- 
cessive additional costs or unreasonable hardship 
to current domiciliary residents who are displaced 
or relocated and that adequate resources either 
exist or are being developed within the appli- 
cants' service area to meet the needs of the dis- 
placed resident. 

(e) Proposals filed bv or on behalf of facilities 
for demonstration special care units must be 
consistent with demonstration special care bed 
need projections and policies in the Nortli 
Carolina State Medical Facilities Plan. 

(f) A proposal to establish a demonstration 
special care unit shall not be appro\'ed il approval 
of the proposal will result in an\' reduction of the 
existing supply of nursing ficilitv beds in the 
ser\ice area. 



(g) A proposal to establish a demonstration 
special care unit must demonstrate that the addi- 
tion of the unit shall not rcsuh in a diminishing 
of sen ices or unreasonable hardship Ui cuiTcnt 
nursing facilit\- patients and or domiciliar> resi- 
dents. 

Statutoty Authority G.S. I3IE-I7"( 1 ). 

.1116 SCOPE OK SEKMCES OFFERED 

(a) Proposals in\'olving the opening of new 
nursing facilities or the con\ersion of existing 
non-nursing ficilit\ beds hom e faciliti e s for the 
provision of skilled nursing t+f intermediat e care 
services shall not be approved unless all current 
licensure standards have been met in accordance 



9-4 



5:15 NORTH CAROLINA REGISTER Novemba- I, 1990 



PROPOSED RULES 



with G.S. Chapter 13 IE, /Vrticle 6, Part A. 
Documentation must be presented to indicate 
that all services required by law can be provided. 

(b) Proposals must delineate services to be of- 
fered and provide assurance that coordination 
will exist between the proponent and other health 
care providers in the service area. 

(c) A proposal to establish a demonstration 
special care unit shall not be approved unless all 
current licensure standards have been met in ac- 
cordance with G.S. 131E, Article 6^ Part A. and 
the facility has not operated on a Provisional 1 i- 
cense and or had its admissions suspended withm 
18 months of the submittal of the proposal. 

(d) A proposal to establish a demonstration 
special care unit must delineate all services to be 
offered for each designated category' ot patient 
proposed to be ser\ed. m the special care unit. 

Statiitoiy Authority G.S. I31E-I77( I ). 

.1117 PROJECTED LTILIZ.VnON/ 
OCCLP.WCV 

(a) A proposal to provide new or expanded 
nursing facility oldllod nurcing ©f inti?rmodiatQ 
6*tfe senices must project an occupanc\' level for 
the entire facility a*. vr#H- 1« fof ti» ■. pc * cifio c . killtjd 
nursing ease aft4 intomiodiato con iceo for each 
of the first eight calendar quarters following the 
completion of the proposed project. /Ml as- 
sumptions, including the specific methodologies 
by which occupancies and case mix are projected, 
must be clearly stated. 

<4h a propo '. ul to pro si do f*ew- »f i? Kpand ^? d 
f i killod nufi ' ing ettfe ' jon ico 'i L i hall fte4- b# appro ' ■ od 
unloos occupancy h^ projoctod te- b** at l e ast 90 
porcont fof tbe total numbor ef skillod nursing 
ewe bods proposed k* bt» oporcitod. »»• krf^f than 
twe yoars lollov . ing t+» complotion ef t+» pro 
posod pro j Oct. laiilhormoro. » proposal y» pro 
vido now e* e xpiindod skillod nursing eafe senicoc 
v«i a FH*t- bt»4 addition to A« facility's total skillod 
nursing afki intonnodiiito eaw l*e4 capacity shall 
He* be approsod unloss occupancy i* projoctod 
te b^ a4- loast W porcont fof tbe total numbor t4 
skillod nursing *h4 intonuodiato &afe bods pro 
posod to b«» op e rated, ho later than two yours 
follossing tfee complotion »f tfee proposed 
project. Att assumption '. , including the specific 
m e thodoUigies by ' i shich occupancios afe 
projoctod. must bt* clearly stated. 

fof fb} .A proposal to pro\'ide new or expanded 
nursmg laciht\' intonnodiato eafe sers'ices shall 
not be approved unless occupancy is projected 
to be at least 90 percent for the total number of 
nursing facility intomiodiato safe beds proposed 
to be operated, no later than two years following 
the completion of the proposed project. Fur- 



thermore a proposal to provide new or expanded 
nursing facility int e rmediata eafe services via a 
net bed addition to the facility's total nursing fa- 
cility skillod nursing aH4 Lntormodiato 6a#e bed 
capacity shall not be approved unless occupancy 
is projected to be at least 90 percent for the total 
number of nursing facility skillod nursing aft4 
intormodiato eafe beds proposed to be operated, 
no later than two years following the completion 
of the proposed projects. /VU assumptions, in- 
cluding the specific methodologies by which oc- 
cupancies and case mix are projected, must be 
clearly stated. 

Statutory Authority G.S. I3IE-I77(I). 

.1118 PROJECTED PATIENT ORIGIN 

(a) A proposal to provide new or expanded 
nursing facility skdlod nursing »f intormodiato 
safe services must project patient origin by per- 
centage by county of residence. .AH assumptions, 
including the specific methodology by which pa- 
tient origin is projected, must be clearly stated. 

(b) A proposal to provide new or expanded 
nursing facility skilled nursing »f intormodiato 
eafe services must show that at least 85 percent 
of the anticipated patient population is within 45 
minutes automobile driving time (one-way) from 
the facility, with the exception that this standard 
may be waived for facilities, such as fraternal or 
religious facihties, aH4 facilities part of residential 
retirement centers and demonstration special care 
units which make services available to large or 
geographically di\erse populations. 

Statutory Authority G.S. I3IE-I77( I ). 

.1 1 19 SITE: BLIIDING: .AND EQUIPMENT 

(a) A proposal to provide new or expanded 
nursing facility skillod nursing ef intomiodiato 
««=« serv'ices must specify the site on which the 
services are to be operated. If such site is neither 
owned by nor under optionlo the proponent, the 
proponent must pro\'ide a written commitment 
to diligently pursue acquiring the site if and when 
certificate of need health planning approvals are 
granted, must specify a secondary site on which 
the services could be operated should acquisition 
efforts relati\e to the primar>' site ultimately fail, 
and must demonstrate that the primary' and sec- 
ondar\' sites are available for acquisition. 

(b) A proposal to pro\'ide new or expanded 
nursing facilit\ skilled ef intormodiato ei+fe ser- 
\ices must clearly demonstrate that consideration 
has been given to factors that may delay or pre- 
vent the de\'eIopment or offering of services on 
the proposed site. 



5:15 NORTH CAROLINA REGISTER November 1, 1990 



975 



PROPOSED RULES 



(c) A proposal to pro\ide new or expanded 
nursing facility c . killod ef intormodiato services 
must pro\ide documentation to show that the 
ser\'ices will be offered in a physical environment 
that conforms to the requirements of federal, 
state, and local regulatory bodies. 

Statutoij Authority G.S. l3IE-n7(l). 

.1120 STAFFING 

fa) A proposal to pro\ide new or expanded 
nursiniz facilit\' r . lcillod nurr i ing e* intonnodiatij 
ea» scnices must pro\ide documentation to 
show that the appropriate numbers and types of 
staff, particularly medical and nursing staff, will 
be available to support the services. 

(b) An appUcant proposing to establish a 
demonstration special care unit shall identifv and 
justif\' the number of staff required and or to be 
utili/ed for services to patients m the following 
categories: 

( 1 ) brain iniur\- rehabilitation. 



( 2) brain iniur\' extended care. 

(3) \entilaior dependence, 

(4) other. 

(c) The applicant shall not be approved unless 
documentation is proMded showing the avail- 
ability and proximity ot credentialed ancillary 
and support staff to the proposed demonstration 
special care umt. 

Statutoij Authority G.S. BIE-Hli 1). 

.1 124 ACCESSlBUir^ TO SFRMCES 

(a) A proposal to provide new or expanded 
nursing facihty beds or a demonstration special 
care unit shall provide assurance that the facility 
will be certified for Medicaid and Medicare re- 
imbursement upon completion of the project. 

(b) The applicant shall provide documentation 
describing the mechanism that wiU be used to 
insure that the projected number of medically 
underserved will be served in the facility. 

(c) The applicant shall provide a copy of the 
written admissions policies identitying any pre- 
payment or deposit requirements for the facility 
and clearh' . stating the admissions requirements 
for the following payor categories: 

( 1 ) priwate pay, 

(2) medicaid beneticiaries. 

(3) medicare beneficiaries. 

(4) uninsured indigent patients, 

(5) undcrmsured indigent patients, and 

(6) fully insured patients. 

(d) The applicant shall provide a written de- 
scription of the billing procedures, including the 
credit collection policies, that will be utilized by 
the facihtv. 



(e) The applicant shall provide assurances that 
residents of North Carolina shall be given prior- 
ity for admission to the demonstration special 
care unit. 

(f) The appUcant shall provide documentation 
that the facility and demonstration special care 
unit win match or exceed the average percent of 
patients in the combined categories of Medicare 
and Medicaid provided by the existing and ap- 
proved nursing facihties in the proposed service 
area. 

Statutoij Authority G.S. 13IE-I27( 1 ). 

•k-k-k-k-k-k-k-k-k-k-k-k-k-k-k-k-k-k 



No 



otice is hereby given in accordance with G.S. 
I SOB- 1 2 that the Division of Social Services in- 
tends to amend rule(s) cited as 10 \CAC 42B 
.1201. .1302; 42C .2001 - .2002. .2006; 478 .0404 
- .0405; 493 .0606; repeal rule(s) cited as 10 
.\CAC42B .0902 - .0903; and adopt nde(s) cited 
as 10 .\CAC46H .0/09. 

J he proposed effective date of this action is 
March I. 1991. 



Th 



he public hearing will be conducted at 10:00 
a.m. on December 5. 1990 at the Disability De- 
termination Services Conference Room, 321 
Chapanoke Road, Raleigh, \.C. 



c 



omment Procedures: Interested persons may 
present their views and comments in writing before 
or at the hearing, or orally at the hearing. Time 
limits may be imposed as deemed necessary by the 
Commission Chairman. A fiscal note has been 
prepared. .Any person may request information 
or copies of the proposed regulations by writing 
or calling Donna A. Creech, Special Assistant, 
Social Services, 325 .\. Salisbury St.. Raleigh. XC 
2^603 (919) 733-3055. 



CMAPTFK 42 



INDINini AI, 
SI PPORT 



AND FAMILY 



SLBCIIAITEK 42B - I ICENSINC; OF HOMES 

FOR DEVELOPMENTALLV DISABLED 

ADLLTS 

SECTION -OWO - IDEN riFMNG 

infok>l\tion 

.0902 grolp homes \\l lii i w o to six 

residents (repealed) 
.0903 (;rolp homes with se\en to 

nine residents (repe.\led) 



9~6 



5:15 AORTH CAROLINA REGISTER November I, 1990 



PROPOSED RULES 



Statutory Authority G.S. BID-2; I43B-I53. 
SF.CTION .1200 - PERSONNEL 

.1201 PERSONNEL REQUIREMENTS 

The qualifications of administrator, co- 
administrator, supervisor-in-charge, manager, 
and co-manager are as follows: 

(1) must be an adult; 

(2) must be a high school graduate or certified 
under the G.I'.D. Program (applies to those 
cmpkned on or after March _f 19*^1); 

(3) (^ must be in good physical, mental and 
emotional health (DSS-1864); 

(4) f^ must provide written documentation 
about convictions of criminal offenses from 
the clerk of court in the county in which the 
conviction was made, and about any driving 
offenses other than minor traffic violations 
from the motor vehicles office; 

(5) f-H must be willing to improve abiUties by 
taking suitable courses oilcred in the local 
community and attending workshops related 
to the management of homes and training 
of developmentally disabled adults. 

Statutory Authority G.S. I3ID-2; I43B-I53; 
168-1; I6S-9. 

SECTION .1300 - THE HOME 

.1302 CONSTRl CTION 

^TTT 1 XIK.' I 1\ I I I \\J tTTTTT .nj 1 \^'\i IT. F I IIJ l\J r^TTTTTTCTTTTT rTTTTTTT 

mc ' L ' t t4w '. tiiiidard ;p s«*t- fuilli » Suction -^^ ef 
Volumo \ el (4*<* North Carolina State Building 
Codo. A copy ef t+H* doouinont ffwy t>** obtaiiiL ' d 
from the Noilh Carolina Department ef hv . ur 
anoe. A^ Noilh Sali 'i hupy Street. Raleiijji, North 
Carolina 27M 1 . 

fb-^ U the capacity i« twe- te sHt-r tt- must meet 
eith e r t+H* abov e mentioned L . taiularJi; . tw the 
!; . timdurd ' j requued ft+f lamily «tfe homes. 

Group homes for developmentally disabled 
adults must meet the applicable requirements of 
the North Carolina State Building Code in force 
at the tune of initial licensure. Ciroup homes 
which increase capacity or v\hich change owner- 
ship must meet the applicable requirements of 
the North Carolina State Building Code in force 
at that time. 



Statutory Authority G.S. I3ID-2: 143D-I53. 

SLBCIIAPIER 42C - LICENSING OF FAMILY 
CARE HOMES 

SECTION .2000 - PERSONNEL 

.2001 QUALIFICATIONS OF 



ADMINISIRATOR 

The administrator must meet certain require- 
ments before and after being approved to manage 
a Ucensed home. The administrator is responsi- 
ble for the home, including the development and 
management of services and accommodations 
and the hiring and training of qualified staff so 
that the home meets the rules of this Subchapter 
even in his absence. 
AH of the foUowing requirements must be met; 

(1) The potential administrator must apply on 
the License Application (DSS-1860). The 
Recommendation for a License (DSS-1861) 
is to be completed by the county department 
of social services and forwarded along with 
references and other appropriate forms to 
the Division of Facihty Services for approval 
or disapproval; 

(2) The administrator must be 18 years of age 
or older; 

(3) The administrator must be willing to work 
with bona fide inspectors and the monitor- 
ing and Licensing agencies toward meeting 
and maintaining the rules of this Subchapter 
and other legal requirements, including those 
of the Civil Rights Act of 1964 when the 
administrator has signed Form DSS-1464; 

(4) The administrator, or a person designated 
in writing by the administrator to act as his 
agent and make decisions on his behalf, 
must meet with the Adult Homes Specialist 
at the Speciahst's request at an agreed time 
in the home as often as necessary to insure 
compliance with the standards; 

(5) The administrator must meet the general 
health requirements specified in Rule .2004 
of this Subchapter; 

(6) The administrator must provide at least 
three current reference letters or the names 
of individuals with whom a reference inter- 
view can be conducted. The individuals 
providing reference information must be 
knowledgeable of the applicant administra- 
tor's background and qualifications and 
must include at least one former employer. 

(7) The administrator must provide written 
documentation about convictions of crimi- 
nal offenses from the clerk of court in the 
county in which the conviction was made, 
and about any driving offenses other than 
mirior traffic violations from the motor ve- 
hicles office; 

(8) The administrator must meet the require- 
ments of either (a) or (b) of this Paragraph 
in accordance with procedures established 
by the Department of I luman Resources; 

(a) The administrator must venfy that he has 
worked in a Ucensed domicihary facility 



5:15 NORTH CAROLINA REGISTER November I, 1990 



977 



PROPOSED RULES 



for at least 30 days in an on-the-job 
training program approved by the De- 
partment of Human Resources: or 
(b) The administrator must verify that he has 
past education, training and experience 
related to the management and operation 
of aduh residential care facUities; 
(0) The administrator must verify that he earns 
15 hours a \ear of contmuing education 
credits related to the management of 
domiciliary homes and care of aged and dis- 
abled persons in accordance with procedures 
established by the Department of Human 
Resources. The requirement for earning 
continuing education credits does not apply 
in those situations where the administrator 
is also a currently Licensed nursing home 
administrator; and 

(10) Persons applying for appro\'al to be an 
administrator must demonstrate an adequate 
working knowledge of the rules of this Sub- 
chapter by passing a written examination in 
accordance with procedures established by 
the Department of Human Resources. 

(11) The administrator (approved on or after 
March ]_. I'J^M ) must be at least a high 
school graduate or certitied under the 
G.E.D. Program. 

Statutoty Authority G.S. 13ID-2: 143B-153. 

.2002 Ql AI.IFICAIIONS OF 

SL PHK\ ISOk-lN-CH ARGE 

The super\isor-in-charge is responsible to the 
administrator for carrsing out the program in the 
home in the absence of the admimstrator. .Ail 
of the following requirements must be met: 

(1) The applicant must complete the Applica- 
tion for Super\isor-in-Charge (DSS-1862); 

(2) The qualifications of the administrator and 
co-administrator referenced in Paragraphs 
(2), (5), (6). and (7) of Rule .2001 of tins 
Subchapter shall apply to the supen,isor-in- 
charge. The super\isor-in-chargc (emplo\"ed 
on or after March L 1^")^1 ) must meet a 
minimum educational requirement bv being 
at least a higlr school graduate or certilied 
under the G.l .D. Program or bv passing an 
altemati\e examination established bv the 
Department of I luman Resources. Doc- 
umentation that these qualifications have 
been met must be on tile in the home prior 
to employing the super\isor-Ln-charge: 

(3) The super\isor-in-charge must be willing to 
work with bonafide inspectors and the 
monitoring and licensing agencies toward 
meeting and maintaining the rules of this 
Subchapter and other legal requirements; 



(4) The super\isor-in-charge must verify that 
he earns 12 hours a year of continuing edu- 
cation credits related to the management of 
domiciliar>' homes and care of aged and dis- 
abled persons in accordance with procedures 
estabhshed by the Department of Human 
Resources; 

(5) WTien there is a break in employment as a 
supenisor-in-charge of one year or less, the 
educational qualification under which the 
person was last employed wlU apply. 

Statutoiy Authority G.S. J3/D-2: 143B-I53. 

.2006 Ql Al IFIC.ATIONS OF ACTIVITIES 
COORDINATOR 

Since activities are a required part of the pro- 
gram of the family care home, there must be a 
designated activities coordinator who meets the 
requirements and qualitications set forth in this 
Rule. 
(1) The qualifications of the administrator and 
co-administrator referenced in Paragraphs 
(2) and (5) of Rule .2001 of this Subchapter 
shall apply to the activities coordinator. 
The acti\ities coordinator (employed on or 
after March J^ 19^1 ) must meet a minimum 
educational requirement bv being at least a 
high school graduate or certitied under the 
G.F .D. Program or bv passing an alternative 
examination established bv the Department 
of Human Resources; 



(2) 1 he acti\ities coorduiator must complete, 
within IS months of employment or assign- 
ment to this position, the 48 hour course 
entitled "The Activities Coordinator Pro- 
gram." A person with a degree in recre- 
ational administration or a related tield 
meets this requirement as does a person who 
completed the required course before the ef- 
fective date of this Rule; and 

(3) The actisities coordinator must be willing 
to work with bona tide inspectors and the 
monitoring and licensmg agencies toward 
meeting and maintaining the rules of this 
Subchapter and other legal requirements. 

Statutoiy Authority G.S. I31D-2: I43B-I53. 

CIIAPIFR 46 - DAY CARE RULES 

SI BCIIAPTER 4611 - POLICIES FOR 
PROMSION OF CIIII I) DAY CARE SERMCES 

SECTION .0100 - GENERAL POLICIES 

.0109 PARENTAL FREEDOM OF CHOICE 

(a) Parents receiving assistance for their cliil- 
drcn under the purchase of care program shall 



9~S 



5:15 yORTH CAROLINA REGISTER November I, 1990 



PROPOSED RULES 



have the right to choose any day care provider, 
approved for participation in the purchase of care 
program under Subchapters 46E, 46F, or 46G of 
these Rules, to provide day care services for their 
eligible children. 

(b) Purchasing agencies administering funds 
under the purchase of care program shall notify 
parents applying for participation in the program 
of their right to choose the approved day care 
provider which will provide day care services to 
their eligible children. 

Statutory- Authority G.S. J43B-/53. 

CH.\PTER 47 - ST.VrE/COLNTY SPECI.AL 
.ASSISr.ANCE 

SLBCHAPTER 47B - ELIGIBILITY 
DETERMINATION 

SECTION .0400 - ELIGIBILITY F.ACTORS 

.0404 RESERVE 

(e) Group II - reserve items counted: 

(17) remainder interest, if salable; 

(18) amount of reverse mortgage remaining in 
the month following the month o\_ receipt. 

(f) Group II - reser\e items excluded: 

(17) irrevocable burial contract; 

( 18) re\erse mortgages in the month of re- 
ceipt. 



Statuton' Authority G.S. IOSA-41: IOSA-46: 
J 43 B-/ 53. 

.0405 INCOME 

(d) Unearned Income not Counted: 

(23) HUD Community Development Block 
Grant funds received to fmance the reno- 
vation of a privately owned residence; 

(24) reverse mortgages. 

Statutory Authority G.S. JOS.4-26; /OSA-4/: 
I43B-I53. 

CHAPTER 49 - AFDC 

SLBCIIAPLER 49B - ELIGIBILITY 
DETERMIN.VnON 

SECTION .0600 - PA'iMENT PROCFDLRES 

.0606 CORRECTION OF 0\ ERPA^MENIS 

(a) If the recipient is not entitled to all or part 
of a check which has been issued and fraud is not 
suspected, the county shall take all reasonable 
steps to recover promptly any overpayment of 
thirty-five dollars ($35.00) or more. 

(b) Overpayments shall be collected as follows: 



(1) voluntary repayment by grant reduction 
or recipient refund; 

(2) involuntap,' repayment by grant reduction; 

(3) if an overpayment occurs due to a county 
error in complying with program regu- 
lations, the overpayment shall be re- 
couped by state office adjustment; 

(4) if an overpayment occurs due to a state 
or county processing error, the overpay- 
ment shall be recouped from the recipient 
providing the recipient was provided 
proper notification of the amount of 
AFDC he was eligible to receive; 

(5) if an overpayment occurs due to a state 
office error in interpreting regulations, the 
overpayment shall be charged to the state. 

(c) A countv may recoup an .\FDC o\'crpay- 
mcnt from a recipient's .AFDC check, on account 
of an o\erpa\ment made to the recipient's 
spouse, parent, cliild. sibling, or other person, 
onlv if the recipient, at the time the owrpavment 
occurred, was: 

( 1 ) IS \ears of age or older. 

(2) li\ing with the person, and 

(3) part of the assistance unit. 

Authority G.S. I43B-I53; 45 C.F.R. 233.20. 

TITLE 15A - DEPARTMENT OF 

EWTRONMENT, HEALTH, AND 

NATURAL RESOURCES 

1\ otice is hereby given in accordance with G.S. 
I50B-I2 that the EU\R - Division of Coastal 
Management intends to adopt rule cited as I5A 
NCAC 7 J .1 109 and amend rules cited as 15.4 
NCAC 7H .0208. .1103. .1203. .1303. .1403, 
.1503. .1603. .1703, .IS03. .1903; 7J .0204. .0404 
- .0406. .0409. 

1 he proposed effective date of this action is 
March I. 1991. 

1 he public hearing will be conducted at 10:00 
a.m. on December 6, 1990 at the \orth Carolina 
Aquarium. Roanoke Island, Manteo, NC. 

C omment Procedures: .All persons interested in 
these matters are imited to attend the public 
hearing. The Coastal Resources Commission will 
receive written comments up to the date of the 
hearing. Any person desiring to present lengthy 
comments is requested to submit a written state- 
ment for inclusion in the record of proceedings at 
the public hearing. .Additional information con- 
cerning the hearing or the proposals mav be ob- 
tained by contacting: Dedra Blackwell, Di\-ision 



5:15 NORTH CAROLINA REGISTER November I, 1990 



979 



PROPOSED RULES 



of Coastal Management, P.O. Box 2^687. 
Raleigh, NC 2761 1-7687. (919) 733-2293. 



(S5n.flO) by check or monev order payable to the 
Department. 



CHAPTER 7 - COASTAL MANAGEMENT 

SLBCHAITER 7H - S FATE GLIDELINES FOR 
AREAS OF ENVIRONMENTAL CONCERN 

SECTION .0200 - THE ESTLARINE SYSTEM 

.0208 USE STANDARDS 

(b) Specific Use Standards 
(1) Na\igation channels, canals, and boat 
basins must be aligned or located so as to 
ayoid primar\' nursery- areas highly pro- 
ductive shellfish beds, beds of submerged 
vegetation, or significant areas of regularly 
or irregularly flooded coastal wetlands. 
(J) Maintenance e.xcavation m canals, 
channels and boat basins within pnmar\' 
nurscp.' areas should be a\-oided- How- 
ever, when essential to maintain a tradi- 



tional and established use, maintenance 

excavation may be appro\'ed if the appli- 

CMTt meets all of the loUo\Mng cntena as 

sh(.n\n bv clear and convincinu evidence 

accompan\'in'-! the permit application. 

( i ) -The applicant can demonstrate and 

document that a water-dependent need 

exists tor the excavation. 

(ii) There exists a previousK- permitted 

channel which was constructed or 

maintained under permits issued bv the 

State and or federal iioveniment. If a 

natural channel was in use, or if a 

human-made channel was constructed 

before permit tine was necessan'. there 

must be clear evidence that the channel 

was conlmuouslv used lor a specific 

purpose. 

(iu) Hxcavated material can be removed 



and placed in an approved disposal area 
without sieniticantlv impacting adjacent 
nurserv' areas, 
(iv) fhe on anal depth and width of a 
human-made or natural channel will 
not be increased to allow a new or ex- 
panded use of the channel. 

Statutory .Autfiority G.S. I I3.-i-/0"(bj: 
113.4-108: II3.l-I/3i'bj: 1 1 3.4- 124. 

SECTION .1 100 - GENERAL PERMIT 
PROCEDl RE 

.1103 PERMir FEE 

rvt* fee vriil- be a '.' jC"j ' ; ' Od fof t4«* p e miit . The 
applicant must pav a permit fee of fifty dollars 



Statutory Authority G.S. 11 3.4- 107 (a); 
l/3.4-107fb); Il3.4-ll3(b): 113.4-118.1; 
113.4-119: 113.4-124. 

SECTION .1200 - GENERAL PERMIT FOR 

CONSTRLCTION OF PIERS: DOCKS: AND 

BOAT HOUSES IN ESTl ARINE AND PLBLIC 

I RLST W ATERS 

.1203 PERMIT FEE 

Xs' fee witt be acoooood fof Ak p e nnit. The 
applicant must pav a permit fee of fifty dolkirs 
( k^(l.t)U) bv check or monev order payable to the 
Department. 

Statutory .4uthority G.S. 1 13A-10y(a): 
113A-107ib!: USA- 113(b): 113A- 118.1; 
113.4-119: 113.4-124. 

SECTION .1300 - (;eneral permit to 

MAINTAIN: REPAIR AND CONSTRUCT BOAT 

RAMPS ALONG ESTl ARINE SHORELINES 

AND INTO ESTLARINE AND PUBLIC TRUST 

\\ArERS 

.1303 PERMIT FEE 

rVfc* fee vriii be aer i OL . OL'd fe>f tbt-r ponnit. "fhe 
applicant must pav a permit fee of fifty dollars 
( j^^ll■^l(l) bv check or monev order payable to the 
Department. 

Statuton' Authnrity G.S. 1 1 3A-10'^ ( a) ; 
113A-l67{b): n3A-ll3ib): I13.4-118J; 
113A-119: 113.4-124. 

SECTION .1400 - GENERAL PERMIT TOR 
CONSTRUCTION OF WOODEN GROINS IN 
ESTLARINE AND PUBLIC TRUST WAFERS 

.1403 PERMIT FEE 

Xa fee wiU- be a^ . L . oi .- jL'd fof tbt^ pemiit. The 
applicant must pav a pennit fee of fiftv dollars 
( j-sll DO) bv check or monev order payable to the 
Depadment. 

Statutory .4uthoritv G.S. 1 13.4- 10" (a!: 
I13.4-l6^(b): l/3A-113ibl: 113.4-118.1: 
113.4-119; 113A-124. 

SECTION .1500 - GENERAL PERMIT FOR 

EXCAX AlION Win UN OK CONNECTING TO 

EXISTING CANALS: CHANNELS: BASINS: OR 

DITCHES IN ESTLARINE WATERS: PLBLIC 

TRLST \\ ATERS: AND ESTU.VRINE 

SHORELINE AEC'S 

.1503 APPLICATION FEE 



9S0 



5:15 i\ORTH CAROLINA REGISTER November 1, 1990 



PROPOSED RULES 



T^ fo? vrtJi ^ ac . ooQood fof tfe* poimit. The 
applicant must pay a permit fee of fifty dollars 
($50.00) bv check or money order payable to the 
Department. 

Statutory Authority G.S. 1 ISA- 107 (a); 
II3A-I07(b): II3A-Il3(b); I/3A-JJS.J; 
II3A-II9: 1I3A-124. 

SECTION .1600 - GENER.\L PERMIT FOR THE 

INSTVI.LATION OF AERI.AL .AND 

SI BAQLEOLS LTILITY LINES WITH 

AT lENDANT STRl CTLRES IN COASTAL 

\\ ETLANDS: ESTLARINE WATERS: PLBLIC 

TRUST WATERS AND ESTLARINE 

SHORELINES 

.1603 PERMIT FEE 

>re- fet» wiU- b(* aoccriL . od fof tfets ponnit. The 
applicant must pay a permit fee of fifty dollars 
($50.00) bv check or money order payable to the 
Department. 

Statutory Authority G.S. 1 1 3-229{c)( I ): 
II3.4-l67(a>: I I3A-I0''(b); 1 I3.i-I l'3(b); 
1 13.4-1 18.1; 1 13.4-119. 

SECTION .1700 - GENERAL PERMIT FOR 

EMERGENCE WORK REQUIRING A CAMA 

AND/OR A DREDGE AND FILL PERMIT 

.1703 PERMIT FEE 

•rM* fee Vrtli V>e a ' ' . r i or . L i od fo+ tfei* permit. The 
applicant must pay a J2£rmit fee of fifty dollars 



.1903 PERM IF FEE 

rve fee Vr4ii be aooef . r . od fof A« permit. 



The 



($50. OU) bv check or money order pa\able to the 
Department. 

Statutory Authority G.S. 113-229(0(1); 
1I3A-I07(a); I I3.4-I07(b); 1 13.4-1 13(b); 
113A-11S.1; 1 ISA- 119. 

SECTION .1800 - GENERAL PERMIT TO 

ALLOW BEACH BULLDOZING LANDWARD 

OF THE MEAN HIGH W.VTER MARK IN THE 

OCEAN HAZARD AEC 

.1803 PERMIT FEE 

Xe fee vrtil be ass e f . r .e d fef <4h* ponnit. The 
applicant must pay a permit fee of fifl\ dollars 
($50.0(1) bv check or monc\" order pa\ able to the 
Department. 

Statutory Authoritv G.S. I l3-229(c)( 1 1; 
l!SA-107(a): 1 13.4-I07[b); 113.4-1 l'S(b); 
1 13.4-1 IS. 1; 1 13.4-1 19. 

SECTION .1900 - GENERAL PERMIT TO 

ALLOW FOR TEMPORARY STRUCTl RES 

WITHIN ESTUARINE AND OCE.AN HAZARD 

A ECS 



applicant must pay a permit fee of fifty dollars 
($50.00) bv check or money order pasable to the 
Department. 

Statutory Authority G.S. 1 13-229(c)( I ); 
11SA-I67(aj; I1SA-I07(b); 113A-113(b); 
1 13.4-1 IS. I; 113.4-1 19. 

SUBCH.APTER 7J - PROCEDURES FOR 

HANDLING MAJOR DEVELOPMENT 

PERMITS: \ ARIANCE REQUESTS: APPEALS 

FROM MINOR DEVELOPMENT PERMIT 
DECISIONS: AND DECLARATORY RULINGS 

SECTION .0200 - APPUIC.VriON PROCESS 

.0204 PROCESSING THE APPLICATION 

(b) Application processing wiU begin when an 
application is accepted as complete. Before an 
application will be accepted as complete, the fol- 
lowing requirements must be met: 

(6) the application fee must be paid as set out 
in this Subparagraph; 
(A) Major de\elopment permit - a check 
or money order payable to the Depart- 
ment for e«e hundred dollars . ($100.00). 
except whoro p e rmiti i afe eliablt* fof 
L ' xpenditiouf . ro' . iij' . v. wt i . vhich (?*t-Te Ae fee 
wtii be twontv fi' . e dollars ($25.00): two 
hundred fifty dollars ($250.00); 

Statutory Authority G.S. 113-229; II3A-I19; 
Il3.4-I22ici; II3.4-I24. 

SECTION .0400 - FINAL APPROVAL AND 
ENFORCEMENT 

.0404 DE\ ELOPMENT PERIOD EXTENSION 

(d) The apphcant for a major deyelopment ex- 
tension request must submit, with the request, a 
check or money order payable to the Department 
in the sum of twontv five doUarc . ($25.00). fifty 
dollars ($50.00). 



Statutory .4uthoritv 

IIS.4-l24(c)(5). 



G.S. 



1 1 3.4- 1 19; 



.0405 PERMIT MODIFIC.VFION 

(e) The applicant for a permit modification 
must submit with the request a check or moncv 
order pa\able to the [department in the sum of 
fifty dollars ( $50.00) tor a minor modification 
and two hundred fifiv dollars ($250.00) for a 
major modification. 

Statutory .4uthority 
I13A-I24(c)(5j. 



G.S. 113-229; 113.4-119; 



5:15 NORTH CAROLINA REGISTER November 1, 1990 



981 



PROPOSED RULES 



.0406 PERMIT ISSUANCE AND TRANSFER 

(f) The applicant for a permit transfer must 
submit with the request a check or money order 
payable to the Department in the sum of filty 
dollars (S50.0U). 

Siatuton' Authority G.S. II3A-I18(c): 
ll3A-li9(a). 

.040'^ ( IMI PK.NAI TIES 

(f) iVmount of Assessment. 
(4) Pursu;mt to Subparagraph (f)(3) of this 
Rule, ci\il penalties for major deyelop- 
ment violations shall be assessed in ac- 
cordance with the following criteria. 
Assessments resulting from an\' violation 
which docs not tit the following cnteria 
shall be made using the best information 
available at the time of the assessment. 

(A) Development which could have been 
permitted shall be subject to a minimum 
civil penalty ef >+»* hundr e d dollars 
( j . l()0.nn). equal to twice the application 
fee and in no case less than two hundred 
fifty dollars ('{-250-()()). This category shall 
include only de\elopment that can. at the 
time of assessment, meet all of the fol- 
lowing four criteria: 

(i) consistency with the local land use 
plan; 

(ii) consistency with the Act and com- 
mission rules; 

(iii) proof of notification of adjacent 
riparian property ouners; and 

(iv) no significant objections from these 
adjacent riparian property owners. 

(B) Civil penalties for development which 
could not have been permitted shall be 
assessed as follows. This categorv' shall 
include de\elopment that is sufficiently 
inconsistent with the local land use plan, 
Act. or commission's rules to have war- 
ranted denial if the permit application 
process had been followed. In all cases, 
restoration shall be required to the fullest 
extent practicable consistent w ith the need 
to a\oid additional d;imagc to the re- 
sources, :md penalties shall be assessed as 
follows: 

(i) Development which m\ol\es wetlands 
alteration or other damage which has 
been coinpletels restored with no per- 
maneiit. irre\ersible. or long-tenn ad- 
\erse impacts on coastd resources shall 
be subject to At» a minimum civil pen- 
alty ©i^ tH<^ huiuhx ' d dollar - - . (SUIO 00); 
eqiial to twice the application fee and 



in no case less than two hundred fifty 
dollars ($250.00); 

(ii) Development which involves d:image 
that was not completely restored but 
did not involve permanent or irrevers- 
ible adverse impacts on coastal re- 
sources, or development which is of 
such a nature that it reflects a reckless 
disregard for its adverse impacts or has 
a high potentid for permanent, long- 
term or irreversible ad\'erse impacts on 
coastal resources, shall be subject to a 
civil penalty one-half of that specified 
for the area affected according to 
Schedule A of this Rule; 

(iii) De\elopment which involves 

wetlands alteration or other damage 
which causes permanent or irreversible 
adverse impacts on coastal resources 
shall be subject to a ci\ il penalty of an 
amount graduated according to Sched- 
ule A of this Rule; 

(iv) Development that does not in\olve 
disruption of an area of a specific size, 
has undetermined impacts, or has im- 
pacts that are ditTicult or impractical to 
determine shall be subject to (4+i* mini 
mum tm^i hundred dollar (i 100.00) a^ 
sosomL'nt; a minimum penalty equal to 
twice the application fee and in no case 
less than two hundred lifts dollars 
(S250.00); or 

(v) .Any structure or part of a structure 
that is constructed in violation of the 
local land use plan, the .Act, or the 
Commission's rules shall be removed 
or modified as is necessar\' to correct 
the violation, and the liable p;irty shall 
be assessed th* minimum penalty »f 
t*fH» hundred dollars (SUlO.OO). a mini- 
mum penaltN equal to twice the appli- 
cation lee and in no case less than two 
hundred fifty dollars ( j.2.>().00). If the 
stnicture is not removed or modified as 
requested, a court order wiU be souglit 
to compel the necessan' removal or 
modification and the liable party shall 
be subject to continuing assessment ac- 
cording to Subparagraph (f)(4)(G) of 
this Rule. 

Statuton- Authorhv G.S. II3A-I24: 

//3A-/ 26(d). 

SECTION .1100 - GENERAL PERMIT 
PROCEDLRE 

.1109 PKR.Mir FEE 



9s: 



5:15 \ORTH CAROLINA REGISTER November /. 1990 



PROPOSED RULES 



The Commission shall estabhsh a processing fee 
for each category of general permits. The fees 
must be paid by check or money order payable 
to the Department. 



Statutory Authority G.S. 
I ISA- 107; I13A-I18.I; 

II3A-I24(c)(5). 



Il3-229(c)(l); 
I13A-II9: 



•k'k'k-k-k-k^:k'k'k'k'k'k-ki<-k-k-k 



1\ otice is hereby given in accordance with G.S. 
J SOB- J 2 that the Water Treatment Facility Oper- 
ators Board of Certification intends to amend 
rule(s) cited as ISA NCAC I8D .0201, .0403 and 
adopt 18 D .0206. 

1 he proposed effective date of this action is 
March I. 1991. 



Th 



he public hearing will be conducted at 9:30 
a.m. on December II. 1990 at the Jane S. 
McKimmon Center, N. C. State University, 
Western Boulevard, Raleigh, .VC 



Co 



omment Procedures: Any person requiring 
information may contact Mr. John C. McFadyen, 
P. O. Box 27687, Raleigh, NC 27611, Telephone 
(919) 733-0379. Written comments may be sub- 
mitted to the above address 30 days prior to the 
public hearing. Written and oral comments may 
also be presented at the public hearing. Notice 
of an oral presentation must be given to the above 
address at least 3 days prior to the public hearing. 

CHAPTER 18 - ENVIRONMENTAL HEALTH 

SLBCHAPTER 18D - \V.\TER TRE,\TMENT 
FACILITY OPERATORS 

SECTION .0200 - QUALIFICATION OF 

APPLICANTS .VND CLASSIFICATION 

OF FACILITIES 

.0201 GRADES OF CERTIFICATION 

Applicants for the various grades of certification 
shall meet the following educational and experi- 
ence requirements: 

(6) Grade A- Well shall have one \ear of ac- 



ccptable cxpcnence 
B-WcU certificate. 



while holding a Grade 



Statutorj- Authority G.S. 90A-2l(c), 



-23. 



.0206 CERTIFIED OPERATORS REQLIRED 

(a) There shall be an operator in responsible 
charge for each water treatment facility. 



(b) There shall be an operator holding at least 
a Class C surface certification or above on duty 
when a Class A or Class B surface water treat- 
ment facility is treatmg water. 

Statutory Authority G. S. 90A-29. 

SECTION .0400 - ISSLANCE OF CERTIFICATE 

.0403 ISSLANCE OF GRADE CERTIFICATE 

(b) To obtain a» At &t Gr 8- woU, »f G w^ a 
certificate the applicant shall satisfactorily com- 
plete an examination; except in the case of a 
temporary certificate or when certification is by 
reciprocity. 

Statutory Authority G.S. 90A-2l(c), -23, -25. 

TITLE 21 - OCCUPATIONAL LICENSLNG 
BOARDS 



No 



otice is hereby given in accordance with G.S. 
I SOB- 1 2 that the North Carolina State Board of 
Certified Public Accountant Examiners intends to 
amend nde(s) cited as 21 NCAC 8 A .01 OS, 
.0301: 8F .OIOS; 8G .0204, .030S; 8H .OOOS; 8J 
.0007 - .0008; 8K .0104 - .OIOS: repeal nde(s) 
cited as 21 NCAC 8G .0306; 8J .0003; and adopt 
rule(s) cited as 21 NCAC 8 A .03 IS; 8G .0310 - 
.0312; 8J .0010; 8M .0101 - .0104. .0201 - .0202, 
.0204, .0206 - .0207, .0301 - .0307. .0401 - .0403. 

1 he proposed effective date of this action is 
March I, 1991. 

1 he public hearing will be conducted at 9:00 
a.m. on December 10, 1990 at the N.C. State 
Board of CP.4 Examiners, 1 101 Oberlin Road, 
Ste. 1041, Raleigh. NC 2760S. 



Cc 



■ omment Procedures: Any person interested in 
these Rules may present oral comments rele\'ant 
to the action proposed at the public rule-making 
hearing or deliver written comments to the Board 
office not later than Monday, November 19, 1990. 
A nyone planning to attend the hearing should no- 
tify the Board office by noon on Monday, No- 
vember 19. 1990, whether they wish to speak on 
the proposals and whether they will speak in favor 
of the proposals or against them. Anyone speak- 
ing on the proposals will be limited to ten minutes. 

CHAPTER 8 - BOARD OF CERTIFIED PUBLIC 
ACCOUNTANT E.XAMINERS 

SUBCHAPTER 8A - DEPARTMENTAL RULES 

SECTION .0100 - ORGANIZATIONAL RULES 



5:15 . NORTH CAROLINA REGISTER November I, 1990 



9S3 



PROPOSED RULES 



.0105 PI RPOSES AND RESPONSIBILITIES 

(c) The Board is composed of fnc persons who 
arc CPAs and two persons who are not CPAs 
but ulio represent the pnbHc at large. B+e 
Bovird f ' ?4Tiff inchidL'f a« I xixuti>o Direct or. v4tt* 
i* a CPA: a nepiil> ' Piroctor: a Dirocior t4' P«»- 
fef ' fional Standard ;. . >*+»*»■ Hr a CP.\: other foii- 
iinu ' ?4a4 moniberf i ; aftd f . e' ie ral piirt timo 
aof . iotajitf . . 

Siatuiofj Amhority G.S. 93-/2. 

SECTION .0300 - DEKIM riONS 

.0301 DEFlNinONS 

(h) In addition to the detlnitions set out in G.S. 
93- l^al. the following definitions ;md other defi- 
nitions in this Section applv when these terms are 
used in 21 NCAC S: 

(,15) "License \ear" means the 12 months be- 
ginning July 1 and ending June 30: 
(16") "Member of a tmn" means anv CP.A 



who has an ow nership interest m a C P.\ 
t'lrm including owners, partners and 
shareholders: 

(17) (4*4 "NASBA" means the National As- 
sociation of State Boards of Accountancy: 

(IS) (-4^ "NCACPA" me;ins the North 
Carolina Association of Certified Public 
Accountants: 

( \^) "North Carolina oft'ice" means an\ office 
ph\'sicalh located in North Carolina: 



'anicip.ilmi; tinn 



ipatmg m SQR 
exempt b\ reason 



means a linn partic- 
Hoes not include timis 



of 21 NCAC SM 



.0102(a) or deemed in comphance pursu- 
ant to 21 NCAC SM .0104: 

(21) (4t!^ "Retired." when used to refer to the 
status of a person, describes one possess- 
ing a North Carohna certificate of qu;ili- 
fication who does not receive any earned 
compensation lor current personal ser- 
vices in an\' job whatsoever: how-ever. this 
does not preclude volunteer services for 
which the retired CPA recei\es no direct 
nor indirect compensation so long as the 
retired CP.\ does not sign any documents, 
related to such senices. as a CPA. Lim- 
ited exemptions may be granted m the 
discretion of the Board onl\" in those m- 
stances when an appHcant for "retired" 
status shows the personal senrces are un- 
related to the field of accounting and the 
apphc:mt verifies no intent to return to 
acti\e status: aft4 

(22) (4^ "Re\enue Dep;irtment" me;ms the 
North Carolina Department of Revenue: 



(23) "Review team" means that team of CPAs 
which re\ieus a linn pursu:mt to the re- 
quirements of Subchapter SNL Mav be 
CO mpnsed of one or more members; 

(24) 'RcN'iew team capl.iin" me.ms that 
member of a re\iew team who is respon- 
sible for the re\ie\v and super\ises the 
other members of the team: 



5} 
2^) 



"RcNiewer" means a member of a re\iew 
team including the re\ iew team captain; 

"S(^")R .Vdx isop>" Committee" means the 

Slate QualilN Rcmcw .AdMson Commit- 
tee to the Board: and 

[2]) ■S.QR Prog-am" means the State Qualitv 
RcMCw Program of the North C.irolina 
Stale Board o[ Cerlilied Public .Vccount- 
ant Fxaminers. 



Siatuuvy Auihority G.S. Q3-I: 93-/2(Sc). 

.03! 2 RKSFRN FD FOR FLIT RE 

COOIFICAIION 
.031.^ RFSFR\FO FOR Fl TCRE 

CODIFICATION 
.0314 RFSFR\FD FOR FCTCRE 

Ct>DlFIC.\TION 

.0315 NFW FIRM, ONtUMNC; FIRM 

(a) Wlien the members of a linn elect to divide 
the fimi such that two or more finns are created, 
one finn may he the ongoing firm and the other 
linns ma\ be new finns. or all ma\ be new firms. 
The ongoing fuTii. if any. is the finn the members 
of which represent more than 50 percent of the 
o\\ nersliip of the predecessor fmn prior to the 
di\ision. 

(b) Wlien two or more finns merge, the re- 
sulting firm may be an ongoing tlrm (successor 
to one of the predecessor firms) or it may be a 
new tlrm. The resulting linn is an ongoing llnu 
if any percentage of ownersliip greater than 50 
percent of one of the predecessor fmns end up 
owning a percentage of the resulting fmn greater 
th;m 50 percent. 

(c) P'or purposes of this Rule, "percentage of 
ownership" refers to the percentage of the linn 
o\\ ned aggregateh' by the group of turn members 
in question. Percentage of ownersliip is deter- 
mined based upon the number of shares held by 
the group if the firm is incorporated or. if the finn 
is a p:irtnership. the percentage of capit;il owned 
by the group. 

(d) A change in an entit\ s fonn (for ex;unple. 
incorporation of what was a partnership) does 
not create a new llnu. .\ new finn is not created 
b\ the addition of a member(s) not acquiring a 
percentage of ownership greater lh;m 50 percent. 
Neither is a new linn created b\ the loss of a 
member(s) by retirement or death, provided the 



9S4 



5.75 yORTH C.iROH.\A REGISTER yovt-mber I, 1990 



PROPOSED RULES 



remaining members have purchased or are pur- 
chasing the retired or deceased members' owner- 
ship, regardless of whether the retired or deceased 
member(s) owned more than 50 percent of the 
firm. 

Note: The following examples Ulustrate this 
Rule: 

(1) Firm A splits into B and C. While A was 
in existence, its members and the respec- 
tive percentage of ownership of those 
members were: Smith, 30 percent; Jones, 
30 percent; and Wesson, 40 percent. 
Smith and Jones form firm B and Wesson 
practices solo in firm C. Since Smith and 
Jones owned 60 percent of firm A, firm 
B wiQ be the ongoing firm. Wesson's firm 
C is a new firm. 

(2) If all the partners in the previous example 
had gone their separate ways, all three 
firms would have been new firms. 

(3) The firm of Miller and Link merges with 
the firm of Thomas and Calaber. Each 
predecessor firm had two partners. It is 
agreed that Miller and Link wiU each own 
26 percent of the resulting firm. There- 
fore, aggregately, they will own 52 percent 
of the resulting firm. The resulting firm 
is the successor firm to Miller and Link, 
and therefore an ongoing firm, because 
Miller and Link aggregately owned a per- 
centage greater than 50 percent of their 
old firm (100 percent) and now 
aggregately own a percentage greater than 
50 percent of the resulting firm (52 per- 
cent). 

(4) If three two-partner fums merge and each 
new partner receives 1/6 of the ownership 
of the resulting firm, the resulting firm is 
a new firm, because, although each set of 
pre\'ious partners owned 100 percent of 
their old firm, no set of previous partners 
owns a percentage of the new firm greater 
than 50 percent. 

Statutory Authority G.S. 93-1; 93-l2(8c). 

SUBCHAPTER 8F - RF.QLIKKMENTS FOR 

CERTIFIED PLBLIC .ACCOUNTANT 

EXAMINATION AND CERTIFICATE 

APPLICANTS 

SECTION .0100 - GENERAL PROVISIONS 

.0105 P.\SSING GRADES 

(a) The following provisions applv to all per- 
sons who apply to take the exammation for the 
first time pnor to the examination scheduled for 
Mav 1994: 



(1) (a) A candidate subject to examination in 

all subjects who receives a grade of 75 or 
higher in each of the four subjects of the 
examination shall have passed the exam- 
ination. 

(2) fb)' A candidate who is subject to exam- 

ination in all subjects of the examination 
and who receives a grade of 75 or higher 
in two or more subjects or the single sub- 
ject of accounting practice shall receive 
credit for the subjects in which he receives 
a grade of 75 or higher and shall have the 
right to be re-examined in only the re- 
maining subject or subjects. 

(3) Effective with the Mav 1994 examination: 

(A) A candidate who has been awarded 
conditional credit for the accounting 
practice section shall be awarded condi- 
tional credit for the proposed accounting 
and reporting section and shall retain such 
credit until he passes the remaining 
sections or until the conditional status of 
such credit expires, whichever occurs first. 

(B) A candidate who has been awarded 
conditional credit for either the auditing 
or the business law (renamed business law 
and professional responsibilities) section, 
or both, shall retain such credit until he 
passes the remaining sections or until the 
conditional status of such credit expires, 
\\ hichc\cr occurs first. 



(C) A candidate who has been awarded 
conditional credit for the accounting the- 
ory' section shall be awarded conditional 
credit for the proposed financial account- 
ing and reportmg section and shall retain 
such credit until he passes the remaining 
sections or until the conditional status of 
such credit expires, whichever occurs tirst. 



(4) fe-^ A candidate receiving conditional credit 

initially as pro\ided for under I'urugraph 
fb^ Subparagraphs (2) and (3) of Para- 
graph (a) of this Rule shall retain credit 
for a period of not more than five suc- 
ceeding examinations offered by the 
Board provided that, for the period during 
which an applicant who was or is in active 
militar,' senrce any time subsequent to 
receiving conditional credit, only those 
examinations for which that applicant has 
apphed and has been approved shall be 
considered as succeeding examinations. 

(5) fd-)' On any re -examination, a conditional 

candidate shall retain credit for each addi- 
tional subject passed for a period of not 
more than the five succeeding examina- 
tions offered by the Bosird. 



5:15 NORTH CAROLINA REGISTER November I, 1990 



985 



PROPOSED RULES 



(b) The following proMsions apply to aU per- 
sons who apply to take the ex^imination for the 
fust time beginmng with the May 19Q4 examina- 
tion: 



01 



A candidate shall be required to pass all 
sections of the examination with a grade 
of 75 or higher. 



(2) .\t a gi\en sitting of the examination, if a 
candidate passes two or more, but not all 
sections, then the candidate shall be giyen 
credit for those sections that he has 
passed, tind need not sit for re- 
examination m those sections, proyided 
that: 

(A) the candidate takes all sections of the 
examination at that sitting: and 

(R) the candidate attains a minimum grade 
of 5U on each section not passed at that 
sitting. 

(3) At each subsequent sitting, candidates who 
ha\'e rcceiyed condition:il credit as pro- 
vided for under Subparagraph (2) of Par- 
agraph (b) of this Rule shall be required 
to: 

(A) take all sections not yet passed: and 

(B) attain a minimum grade of 50 on 
sections taken but not passed at such sit- 
ting. 

(4) A candidate recei\ing conditional credit 



SECTION .0200 - RESPONSIBILITIES TO 
CLIENTS .AND COLLE.\GLES 

.0204 CONFIDENTI.AL CLIENT 
IN FORM. ATI ON 

fc) It is not a violation of this Rule to disclose 
confidential client information necessan' for the 
SQR process or for any \'alid quality re\iew 
program. 



Statutory A uthority 
93-12(9). 



G.S. 55B-I2: 93-12(Sc): 



SECTION .0300 - OTHER RESPONSIBILITIES 

.0.305 N.VME OR STYLE OF .\ PR.ACTICE 

(a) A firm engaged in the public practice of 
accounting may not use any false or misleading 
name, title, or reference in its name or associated 
uith its name. 



(b) \l is considered misleading if a finn prac- 
tices A CPjV i ' hall fttrt practice) under a name or 
style yyhich \\ ould tend to imply the existence of 
a partnership or a professional corporation or an 
association when in fact there is no partnership 
nor is there more than one shareholder in the 
firm. For example, no firm ha\ing just one 
owner may have as a part of its name the words 
"associates" or "company'' or their abbre\'i- 
ations. 

Statuttvy Authority G.S. 55B-5: 93-12(9). 

.0306 FIRM NAME OR STYLE OF .\ 
PR.ACTICE (REPE.\LED) 



ill 



initially as provided for under Subpara- 
graphs (2) and ( 3 ) of Paragraph (b) of this 
Rule shall retain credit for a penod of not 
more than the six succeeding examina- 
tions ottered by the Board provided that. 
for the penod dunng which an applicant 
who was oi 11 in ■ic'^''^''-' militar\' sen.ice 
any time subsequent to receiving condi- 
tional credit. onl\- those examinations for Statutoiy .Authority G.S. 55B-5: 93-12(9). 
which that applicant has applied and has 
been approved shall be considered as suc- 
ceeding examinations. 

On any re-examination. a conditional 
candidate shall retain credit for each addi- 



l£i 



tional sub|ect passed for a period of not 
more than the six succeeding examina- 
tions offered bv the Board. 
I he Board may m particular cases waive 
or defer any of the requirements of Paragraphs 
(a I and (b) of this Rule regarding the circum- 
stances in which the various parts of the exam- 
ination must be passed, upon a shov\ ing that, by 
reason o\_ circumstances bevond the candidate s 
control, he was unable to meet such requirement. 

Statutoty Authority G.S. 93-J2i3); 93-12(5). 

SL BCLLVPTER 8G - PROFESSION.\L ETHICS 
.\ND CONDUCT 



.0310 PR.\CTICF THROl GH A 

NON-COMPLMNG FIRM PROHIBIIED 

(a) A CPA shall not engage in the public 
practice of accountancy through a tlrm vyhich is 
in violation of the registration requirements of 
21 NCAC SJ .0008, 8J .0010 or the SQR re- 
quirements of 21 NCAC 8M .0102. 

(b) If a finn fails to comply vyith any part of 
21 NCAC SJ .0008, 8J .0010 or 8M .0102, the 
Board may take disciplinary action against the 
firm's members. Such discipline mav include but 
is not limited to: 

(1) a conditional license upon such conditions 
as the Board ma\' deem appropriate for 
the first 60 days of non-compliance: 

(2) a conditional license and one hundred 
doUars ($100.00) civil penalty for non- 
compliance in excess of 60 da\ s but not 
more than 120 days; 



9S6 



5:15 NORTH CAROLINA REGISTER November I, 1990 



PROPOSED RULES 



(3) a suspension of each member's CPA cer- 
tificate for a period of not less than 30 
days for non-compliance in excess of 120 
days. 



Statutory Authority G.S. 
93-12(9). 



.0311 



55B-I2; 93-I2(8c): 



FALSIFICATION IN CONNECTION 
WITH QLALITY REVIEW PROGRAMS 

A CPA shall not falsify a review, report, or any 
required program or checklist of any quality re- 
view program. 

Statutory Authority G.S. 93-12(9). 

.0312 QLALITY REVIEW STANDARDS 

A CPA who is engaged to perform a qualit>' 
review shall not violate the rules or standards of 
the quality review program under which the re- 
view is made. 

Statutory Authority G.S. 93-12(9). 

SLBCHAPTER 8H - RECIPROCITY 

.0005 LSE OF CPA TITLE 

(c) Out-of-state CPAs neither domiciled nor 
employed in North Carolina may enter the state 
for the sole purpose of pcrformini; a peer review 
or quality review for a North Carolina licensee 
and shaU not be required to secure a temporary 
permit to conduct said enaaaement. 

Statutory Authority G.S. 93-1. 

SLBCHAPTER 8.1 - RENEWALS AND 
REGISTR.VTIONS 

.0003 REPORTS AND ANNLAL 

REGISTR.VTION OF OFFICES .VND 
PARTNERSHIPS (REPEALED) 

Statutory .Authority G.S. 93-12(9). 

.0007 MAILING ADDRESSES OF 

CERTIFIC.VTE HOLDERS AND FIRMS 

/Ml certificate holders and firms shall notify the 
Board in writing within 3f> 30 days of any change 
in address or business location. 

Statutory Authority G.S. 55B-I2; 93-l2(7b); 
93-12(9). 

.0008 FIRVl REGISTR.VTION 

(af L ' pon opening a North Carolina offic e aR4 
annually thoroaftor by Ducumbor ^4t non 
incorporatod CPi\ firma, whothor sei<? 
proprit-'torships ©f partnortilripo, vshich havo ef- 



6ee« both within aft4 outaido the state ef North 
Carolina muot rogiotor ¥4tfe the Board. 

/ t-v \ V 1 t .--t-i T ■ rt-tn c- f Vi o 11 ra^^ct^^^ i T r-i t l-i Jj^a li^^^^z^i l^^^i 

fJ^ filing with the Board offic e aH- forms Fe- 

q«tfed by 34- > . CAC U .QQQ^ aR4 
(5} paying tbe rogistration foe fof multi otato 
non incorporatod firms. 
(e) ¥h© registration fee fof eaefe multi otato, 
non incorporatod fiff» shall be dotorminod by 
multiplying the numbor &f own e rs tft the fen* by 
teft dollars ($10.00) if the numbor &f ownoro m 
the fiH» is les6 than 3^0r Howovor, if the numb e r 
ef ownors m the (vem is 2^ ©f groator, the fee 
wm be tw«- thousand five hundred doUaro 
($3,500). 

(a) AU CPA firms must register with the Board 
within 30 days after opening a North Carohna 
office or beginning a new firm unless they are to 
be incorporated, in which case they must re.gister 
prior to Incorporation pursuant to 2]_ NCAC 8K 
.0104. 

(b) In addition to the Initial registration re- 
quired by Paragraph (a) of this Rule, all CPA 
firms must register annually by January 31 with 
the Board upon forms provided by the Board. 

(c) The information provided by the registra- 
tion shall mclude: 

( 1) Either an application for exemption from 
SQR. a request to be deemed in compli- 
ance with SQR or registration for SQR, 
pursuant to 21_ NCAC 8M .0102 and 
.0104; 

(2) For all firms not exempt from the SQR 
program, with the registration imme- 
diately following its review, the affidavit 
required bv 21 NCAC 8M .0102(d); 

(3) For all North Carolina offices, an office 
registration form indicating the name of 
the office supervisor, the location of the 
office and its telephone number; 

(4) For all partnerships, a list of all resident 
and nonresident partners of the partner- 
ship and their percentage of ownership as 
set forth in 21 NCAC 8A .0315; 

(5) For all incorporated firms, the information 
set forth m 21 NCAC SK .0104(d): and 

(6) For aU fums, the appropriate registration 
fees as set forth m 21 NCAC 8J .0010. 

(d) All information provided for registration 
with the Board shall pertain to events of and 
action taken during the year preceding the year 
of registration. The last day of the preceding 
calendar year is the "vear-end". 

(e) With regard to Paragraph (c)(3) of this 
Rule, one representative of a firm may file all 
documents with the Board on behalf of the firm's 
offices in North Carolina. However, responsi- 



5:15 NORTH CAROLINA REGISTER November I, 1990 



987 



PROPOSED RULES 



bility for compliance with this Rule will remain 
with each office supervisor. 

(li With regard to Paragraph (c)(4) of this Rule, 
one annual listing by a representative of the 
partnership shall satisfy the requirement for all 
partners of the firm. However, each partner shall 
remain responsible for compliance with this 
Rule. The absence of a fding under Paragraph 
(c)(4) of this Rule shall be construed to mean 
that no partnership exists. 

(g) Notice that a firm has dissolved and any 
change in the information required by Paragraph 
(c)(3) and (4) of this Rule must be dcU\'ered to 
the Board's office within 30 days after the change 
or dissolution occurs. 

(h) If a firm fails to comply with anv part of 
this Rule, the Board may, in its discretion and for 
good cause shown, grant the fum a conditional 
registration for a period of 60 davs or less within 
which the firm must comply with the provisions 
of this Rule. The Board may grant a second 
further extension under extenuating circum- 
stances. 

Statutory Authority G.S. 55B-I0; 55B-I2; 

92-l2(Sa); 93-l2(8c). 

.0009 RESERVED FOR FLTURE 
CODIFICATION 

.0010 REGISTR.\TION FEES 

The annual registration fees shall be as follows: 

(1) For exemption from SQR, ten dollars 
($10.00); 

(2) For participation within SQR or for a re- 
quest to be deemed in comphance with 
SQR, seventy-five doUars (J75.00) plus five 
dollars ($5.00) for each additional North 
Carolina office of the firm not excused from 
SQR by 21 NCAC 8M .0204; 

(3) For all incorporated firms, twenty-five dol- 
lars ($25.00); and 

(4) For all non-incorporated firms which have 
offices both within and outside the state of 
North Carolina, whether sole 
proprietorships or partnerships, an amount 
equal to two thousand five hundred dollars 
($2,500.00) or the number of owners of the 
firm multiphed by ten dollars ($10.00), 
whichever is less. 

Statutory Authority G.S. 55B-II: 55B-J2: 
93-l2(7b): 93-I2'(Sa); 93-12(8c). 

SLBCHAPTER 8K - PROFESSIONAL 
CORPORATIONS 

SECTION .0100 - GENERAL PROVISIONS 



.0104 REGISTRATION AND RENEWAL 

(c) Prior t» Dooombor 3-1- ©f each yoar. In addi- 
tion to its initial registration, every CPA corpo- 
ration, whether domestic or foreign, must ronow 
its rogiotration with Ae Board by oubmitting t» 
tfee Board'o office?: 

f4^ a proporly oomplotod profosoional corpo 
ration annual registration form; aft4 

^ a fee &f twenty fivo dollaro ($25.00). 
must register annuaUv pursuant to 2]_ NCAC 8J 
.0008. 

(d) The applications application for registration 
aft4 tfe« registration ronuwal application ' . ' ■ hen 
completed by a CPA corporation shall eaefe 
provide the following information: 

(1) the name and address of the professional 
corporation; 

(2) the address of each office operated or 
maintained by the corporation; 

(3) the names and addresses of all the offic e rs, 
dirootoro, afi4 shareholders; aft4 officers 
and directors; 

(4) the names and addresses of all the share- 



holders and their percentage of ownership 
as set forth m 21 NCAC 8A .0315(c); and 
(5) (44 the names and addresses of all the em- 
ployees of the corporation Licensed by the 
Board under the provisions of Chapter 93 
of the General Statutes of North Carolina. 

Statutory Authority G.S. 55B-1I: 93-S; 
93-I2(7b): 93-l2(8c). 

.0105 SUPPLEMENTAL REPORTS 

(b) Within ^ day* aftef ftfty chang e occurs. In 
addition to the supplemental reports required by 
21_ NCAC 8J .0008(g), professional corporations 
registered with the Board pursuant to G.S. 55B 
shall report aay chang e s » Ae composition ef 
identity »f shareholders, officers, directors »f 
CPj\ employees. They shall file a certified copy 
of all amendments to the articles of incorporation 
within 30 days after the effective date of each 
amendment. They shall also file a copy of any 
amendment to the by-laws, certffied to be a true 
copy by the secretary or an assistant secretary of 
the corporation, within 30 days after adoption of 
the amendment. 

Statutory .Authority G.S. 55B-/2; 93-12(3). 

SLBCHAPTER 8M - ST.\TE QUALITY REVIEW 
PROGRAM 

SECTION .0100 - GENER.VL SQR 
REQUIREMENTS 

.0101 PURPOSE 



9S8 



5:15 NORTH CAROLINA REGISTER November I, 1990 



PROPOSED RULES 



TTie Board has adopted a state quality review 
(SQR) program to help CPA professionals in the 
public practice of accountancy maintain the 
quality of their audit, review and compilation 
services. Participation in the program does not, 
however, guarantee or warrant that any services 
rendered by the reviewed firm do or will comply 
with the applicable professional standards. 

Statutory Authority G.S. 93-l2(8c). 

.0102 REGISTR.\T10N REQUIREMENTS 

(a) A firm which has not performed any audits, 
reviews or compilations during the 12 months 
prior to the year-end of the registration required 
by 21 NCAC 8J .0008(a) and (b) shall be exempt 
from the SQR program for the 12 months fol- 
lowing the year-end but not from registering with 
the Board. 

(b) Unless exempt under Paragraph (a) of this 
Rule, each ongoing firm must complete an SQR 
within 12 months following the year-end of each 
registration unless it has completed an SQR 
within 24 months prior to the year-end. 

(c) Unless exempt under Paragraph (a) of this 
Rule, a new tirm shall complete its initial SQR 
within 24 months of the date of its initial regis- 
tration pursuant to 21 NCAC 8J .OOOS(a). 

(d) Every firm not exempt from SQR by Par- 
agraph (a) of this Rule, after completion of a 
quality review, must procure an affidavit signed 
by the review team captain stating that the firm 
has completed an SQR or one of the re\iew 
programs listed or referred to in 21 NCAC 8\1 
.0104. The firm shall submit the affidavit with 
the annual registration following the review as set 
forth in 21 NCAC 8J .0008(c)(2). 

(e) For purposes of this Rule, an SQR is 
complete when the review team has delivered its 
report required by 21 NCAC 8M .0307 to the 
re\'iewed firm. Any quality review other than 
SQR is complete when the review team has de- 
livered its final report to the reviewed firm. If 
mailed, a report shall be deemed delivered when 
postmarked. 

Note: For example, firm C was incorporated on 
June 1, year one. During that year it performed 
accounting and auditing services and, therefore, 
was not exempt from the SQR program. It 
continued to do auditing and accounting work 
for the next three years (years two, three and 
four) but it did not do any audits, reviews, or 
compilations in years five and six. In year seven, 
the firm completed several compilations but, in 
year eight, it did not issue any audits, reviews, or 
compilations. In year nine, the corporation dis- 
solved, at which tmie it notified the Board of its 
dissolution pursuant to 21 NCAC 8J .0008(g). 



The following chart shows the histor>' of firm C 
as it relates to the SQR program, SQR fees it was 
required to pay pursuant to 21 NCAC 8J .0010, 
and when and why it was required to complete 
an SQR pursuant to this Rule. 



Year 



Audits, Reviews 

or Compilations 

Performed 

Yes 
Yes 



Yes 



Yes 



No 



No 



Yes 



Fee 



SQR Fee 
SQR Fee 



SQR Fee 



SQR Fee 



E.xempt Fee 



Exempt Fee 



SQR Fee 



No 



Yes 



Exempt Fee 



No Fee 



Completion of SQR 
Required and Rationale 

A new firm has 24 months to complete SQR - 
21 NCAC 8M .0102(c); the firm is required to 
complete SQR before June 1, year 3. 



Completes SQR on .May 15, year 3 (within 24 
months of its inception) - 21 NCAC 8M 
.0102(c). 

Not required to complete SQR in year 5 because 
the firm completed SQR on .May 15, year 3 



5:15 NORTH CAROLINA REGISTER November I, 1990 



989 



PROPOSED RULES 



(within 24 months of year-end of year 4) - 21 
NCAC 8M .0102(b). 

\^'ill not be required to complete SQR in year 6 
because it is exempt - 21 NCAC 8M .0102(a). 

Not required to complete SQR in vear 7 because 
it is exempt - 21 NCAC 8M .0102(a). 

Will be required to complete SQR in year 8 be- 
cause it has not completed SQR within 24 
months of vear-end of vear 7 (last SQR was 
completed May 15, vear 3) - 21 NCAC 8M 
.0102(b). 

Completes SQR pursuant to its registration in 
year 7 - 21 NCAC 8M .0102(b). 

Not required to register or pay a fee at year-end 
of year 9 because firm dissolved during year 9 and 
properlv notified the Board - 21 NCAC 8J 
.0008(g). 

Statutory Authority G.S. 93-12(7bi: 93-l2(8c). 

.0103 PROHIBITION OF .4BLSE 

Firms may not rearrange their structure or act 
in any other manner in order to avoid partic- 
ipating in SQR. 

Note: For example, two years after its inception, 
the two-partner firm of Wolf and Calder changes 
its name to Calder and Wolf and rearranges its 
capital ownership slightly so that Calder now 
owns 60 percent, whereas when the fum first be- 
gan Wolf owned 60 percent of the fum. The 
Board would not recognize the firm of Calder 
and Wolf as a new firm and would require it to 
undergo SQR that vear rather than in another 
two years. See 21 NCAC 8M .0102(b) and fc). 

Statutory Authority G.S. 93-12(8cj. 

.0104 FIRMS DEEMED IN COMPLI.\NCE 

(a) Firms which have participated in one of the 
review programs set forth in either Paragraph (b) 
of this Rule or the Ust referred to in Paragraph 
(c) of this Rule, rather than SQR, withm the ap- 
plicable time period prescribed by 21 NCAC 8\1 
.0102(b) and (c) are deemed to be in compliance 
with the SQR program. 

(b) The following quality re\iew programs are 
found by the Board to be of the t\pe required 
bv the Board in its SQR proaram: 

' (1) AICPA SECPS division for CPA fums, 

(2) AICPA PCPS division for C?.\ firms, and 

(3) AICPA Quality Review Program. 

(c) Other quality review programs may be of 
the type required by the Board in its SQR pro- 



gram. A list of such programs will be maintained 
at the Board offices and mailed to any firm upon 
request. 

(d) Pursuant to G,S. 93-12(8c), a firm which 
contemplates undergoing a quality review pro- 
gram other than the SQR program or those listed 
or referred to in Paragraphs (b) and (c) of this 
Rule may request a determination from the 
Board whether the quality review program is of 
the type required by the Board in the SQR pro- 
gram. The firm shall supply all information re- 
quested of it by the Board and, within two 
months of the month all inlbrmation requested 
has been received by the Board, the Board shall 
make its determination and notify the fum. 

Statutory Authority G.S. 93-12(8c)(e). 

SECTION .0200 - DUTIES OF THE REVIEWED 
FIRM 

.0201 SELECTION OF ENG.\GEMENTS TO 
BE RE\ lEWED 

(a) Each office of the reviewed fum not excused 
under 21 NCAC 8M .0204 shall select a set of 
three engagements to be submitted for review. 

(b) A set of engagements for review shall in- 
clude the accountant's report and fmancial state- 
ments for one audit, one review, and one 
compilation, if these three levels of service have 
been performed by the office within the 12 
months preceding the year-end. 

(1) If one or more levels of ser\'ice have not 
been performed, the office shall select re- 
ports of the next highest level of ser%'ice 
for a total of three reports submitted. 

(2) If, of the three levels of service, only 
compilations have been performed by the 
office, the set of three engagements shall 
include at least one compilation report on 
a complete set of fmancial statements 
which includes disclosures and one com- 
pilation report on a financial statement 
where management has elected to omit 
substantially all of the disclosures 
normally required by generally accepted 
accounting principles set forth in 21 
NCAC 8G .0102, if both types of compi- 
lations are performed. 

(c) The set of engagements, if possible, shall 
include clients operating in different industries. 
For example, submission of one governmental 
audit, one manufacturing review and one con- 
tractor compilation would satisfy this require- 
ment. 

Statutory Authority G.S. 93-l2(8c). 

.0202 NOTICE TO CLIENTS 



990 



5:15 NORTH CAROLINA REGISTER November 1, 1990 



PROPOSED RULES 



The participating firm may advise its clients that 
it will participate in a quality review required by 
the Board and that the client's accounting or au- 
diting work may be part of the review process. 

Statutory Authority G.S. 93-l2(8c). 

.0203 RESERVED FOR FUTURE 
CODIFICATION 

.0204 CERTAIN OFFICES EXCUSED 

The following offices of participating firms are 
not required to participate in the SQR program: 

(1) offices which are not North Carolina of- 
fices, and 

(2) North Carolina offices which have not 
performed any audits, reviews or compila- 
tions for the 12 months prior to the year-end 

-^ set forth in 21 NCAC 8J .0008. 

Statutory Authority G.S. 93-l2(8c). 

.0205 RESERVED FOR FUTURE 
CODIFICATION 

.0206 SELECTION OF A REVIEW TEAM 

(a) A participating firm shall select the review 
team which will perform the firm's SQR. 

(b) It is the participating -firm's responsibility 
to see that the review team is qualified under 21 
NCAC 8M .0301 and engaged to perform the 
review in accordance with the standards for the 
performance of SQR set forth in 21 NCAC 8M 
.0302 - .0307. 

Statutory Authority G.S. 93-l2(8c). 

.0207 DUTY TO RESF'OND TO QUESTIONS 

(a) The participating fum shall respond 
promptly to questions raised during the review 
process by any member of the review team, 
whether oral or written. 

(b) The participating firm shall respond in 
writing to questions raised by the SQR report 
required by 21 NCAC 8M .0307 within 30 days 
from the date the report is delivered to it. The 
letter of response shall be addressed to the SQR 
Committee and a copy sent to the review team 
captain. 

Statutory Authority G.S. 93-l2(8c). 

SECTION .0300 - REVIEW TEAM: 
QUALIFICATIONS AND DUTIES 

.0301 QUALIFICATIONS OF REVIEWERS 
AND TEAM CAPTAINS 

(a) A reviewer must be a CPA on active status 
licensed in any state of the United States, be m 



good standing with the CPA boards by which 
(s)he is licensed, possess current knowledge of the 
code of professional ethics and conduct, and 
possess current knowledge of the accounting and 
auditing standards applicable to the engagements 
to be reviewed by him/her. However, (s)he need 
not possess knowledge of the applicable ac- 
counting and auditing standards with regard to 
every engagement involved in the review, unless 
(s)he is the only member of a review team. 

(b) A reviewer shall not have been disciplined 
for violation of 21 NCAC 8G .0311 or .0312 
within the five years preceding the date the review 
engagement is entered. 

(c) The review team captain: 

(1) must have five years' experience or more 
as a CPA in the accounting and auditing 
function; 

(2) must be a member or employee of a firm 
which has completed an SQR or other 
quality review listed or referred to in 21 
NCAC 8M .0104 within the last three 
years but which has not received an ad- 
verse report on its most recent quality re- 
view; 

(3) must be a manager (or the equivalent) 
within his/her firm; and 

(4) must have day-to-day involvement in au- 
diting and accounting procedures which 
is sufficiently comprehensive to enable 
him/her to perform and oversee the SQR 
with professional expertise. 

Statutory Authority G.S. 93- 12 (8c). 

.0302 INDEPENDENCE FROM A REVIEWED 
FIR.VI 

(a) A reviewer shall be independent with re- 
spect to the reviewed firm. 

(b) Independence is impaired if a reviewer: 

(1) perfonns an SQR of a firm which per- 
formed the most recent quality review of 

- the reviewer's firm; 

(2) performs an SQR of a fum an employee 
or member of which performed or partic- 
ipated in the performance of the most re- 
cent quality review of the reviewer's firm; 
or 

(3) has any direct or indirect fmancial interest 
in a reviewed firm's client and reviews en- 
gagement performed for that client. 

(c) Paragraph (b) of this Rule does not include 
all instances where a reviewer's independence 
would be impaired. In considering whether in- 
dependence is impaired, the reviewer shall con- 
sider -the effect of family and other relationships 
and the possible appearance of loss of independ- 
ence as a result of those relationships. 



5:15 NORTH CAROLINA REGISTER November 1, 1990 



991 



PROPOSED RULES 



Statutory Authority G.S. 93-l2(8c). 

.0303 CONFLICT OF INTEREST 

(a) A reviewer shall not have a conflict of in- 
terest with respect to the reviewed firm or the 
clients whose engagements are selected for re- 
view. 

(b) A reviewer shall a\'oid contacts with the 
reviewed firm's clients or persormel that could 
be asserted to be e\idence of a conflict of interest. 

Statutory Authority G.S. 93-I2(8c). 

.0304 PERFORMING THE REMEW - 
REMEWER'S DUTIES 

(a) The objecti\'e of the review shall be to de- 
termine that the financial statements and related 
accountant's report on the audit, review and or 
compilation engagements submitted for re\iew 
do not depart in a material respect from the re- 
quirements of professional standards set forth in 
21 NCAC 8G .0201 - .0203 and 8G .0208 - .0212. 

(b) The review team shall read the fmancial 
statements submitted by the participating firm 
and the accountant's audit, review or compilation 
report thereon. 

(c) The review team must determine whether 
each of the accountant's report and financial 
statements conform with the applicable profes- 
sional standards set forth in 21 NCAC 8G .0201 
- .0203 and 8G .0208 - .0212. 

(d) Before issuing its SQR report pursuant to 
21 NCAC 8.M .0307, the review team may raise 
questions with the participating firm either orally 
or in written form to resolve questions which 
come to their attention during a review. 

(e) The review team shall document the work 
performed using programs and checklists which 
provide a reasonable basis for their SQR report. 

(f) A review team shall not issue an SQR re- 
port, pursuant to 21 NCAC S.VI .0307, unless it 
has complied with the applicable review stand- 
ards and requirements. 

Statutory Authority G.S. 93-12(8c). 

.0305 CONFIDENTI.\LITV 

Information concerning the participating firm 
or its clients or personnel that is obtained as a 
consequence of the review is confidential and 
must not be disclosed to anyone not invohed in 
the SQR process. 

Statutory Authority G.S. 93-12(8c). 

.0306 DLE PROFESSIONAL C.\RE 



A reviewer must exercise due professional care 
in performing and reporting on an SQR. 

Statutory Authority G.S. 93-l2(8c). 

.0307 REPORTING REQUIREMENTS 

(a) The review team shall deliver an SQR re- 
port and the affidavit required by 21 NCAC 8M 
.0102(d) to the participating firm within 60 days 
after all of the engagements which are to be re- 
viewed have been delivered to it. Beginning 
January 1, 1996, the review team shall also de- 
liver its SQR report to the SQR Advisor>' Com- 
mittee by the same date. 

(b) The SQR report and a letter of comment, 
if any, shall be written and issued on the letter- 
head of the team captain's firm and shall either 
be unmodified, modified, or ad\'erse. 

(c) It is suggested that a letter of comment be 
issued if the report is modified or adverse. The 
letter of comment should provide reasonably de- 
tailed recommendations for remedial, corrective 
actions by the participating firm so that the SQR 
Committee can evaluate whether the firm's re- 
sponse to significant deficiencies noted in the re- 
view is a positive one, consistent with the 
objectives of the SQR program, and whether the 
actions taken or planned by the participating firm 
appear appropriate m the circumstances. 

(d) The SQR report shall describe the limited 
scope of the review and shall not express an 
opinion or any form of assurance about the re- 
viewed firm's quality control policies and proce- 
dures for its accounting practice. It shall state 
whether an>lhing came to the attention of the 
review team which caused them to believe that 
any of the engagements submitted for review did 
not conform with the requirements of profes- 
sional standards in all material respects and, if 
applicable, describe the general nature of signif- 
icant departures from those standards. 

(e) An unmodified report includes the review 
team's conclusion that nothing came to its at- 
tention that caused its members to believe that 
the engagements submitted for review did not 
conform with the requirements of professional 
standards in all material resj>ects. 

(f) .A modified report mcludcs the review team's 
conclusion that nothing came to its attention that 
caused its members to believe that the engage- 
ments submitted for review did not conform with 
the requirements of professional standards in all 
material respects with the exception of certain 
reservations which are noted in the report. 

(g) .-Vn adverse report includes the review 
team's conclusion that the participating firm did 
not have reasonable assurance of conforming 



992 



5:15 NORTH CAROLINA REGISTER November 1, 1990 



PROPOSED RULES 



with professional standards in the conduct of its 
accounting practice during the year under review. 

Statutory Authority G.S. 93-l2(8c). 

SECTION .0400 - SQR ADVISORY COMMITTEE 

.0401 SQR ADVISORY COMMITTEE - 
MEMBERS AND DUTIES 

(a) The SQR Advisory Committee shall consist 
of six CPAs appointed by the Board and one 
Board member appointed by the Board's Presi- 
dent. 

(b) The SQR Committee shall: 

(1) review all initial firm registrations submit- 
ted to the Board pursuant to 21 NCAC 
8J .0008(a); 

(2) review all affidavits submitted by review 
team captains to the reviewed fum pursu- 
ant to 21 NCAC 8M .0102(d) and sub- 
mitted to the Board pursuant to 21 
NCAC 8J .0008(c)(2); 

(3) begirming January 1, 1996, review all 
modified and adverse SQR reports and 
letters of comments, if any, submitted by 
review team captains under the SQR pro- 
gram; 

(4) consider all objections fded pursuant to 
21 NCAC 8M .0402(a); and 

(5) make recommendations to the Board 
consistent with these Rules concerning 
each of Subparagraphs (b)(1) through (4). 

(c) Prior to making any recommendations to 
the Board, the Committee shall give notice of its 
proposed recommendation to the fum to which 
the recommendation pertains. 

(d) The Committee shall also recommend re- 
medial action to participatiag firms receiving 
modified or adverse reports which, if followed, 
could increase the participating firm's ability to 
perform quality services in the public practice of 
accounting. 

(e) The Committee shall report at least annu- 
ally to the Board on its activities and, further, at 
any time the Board requests a special report. 

Statutory Authority G.S. 93-12(2); 93-12(8c). 

.0402 OBJECTIONS TO-SQR ADVISORY 
COMMITTEE 

(a) A participating firm may file an objection 
with the SQR Advisory Committee with regard 
to an SQR report within 30 days from the date 
the report is delivered pursuant to 21 NCAC 8M 
.0307(a). In any other matter before the Com- 
mittee, a firm to which a proposed recommen- 
dation pertains may file an objection within 30 
days from notice of the Committee's recommen- 
dation. 



(b) AH objections shall be in writing and shall 
be addressed to the Committee at the Board's 
address set forth in 21 NCAC 8A .0102. Ob- 
jections are filed when received by the Board. 

(c) An objection concerning an SQR report 
shall contain: 

(1) the name of the reviewed firm; 

(2) the name of the review team captain; 

(3) the date the review was completed; 

(4) the conclusions made in the report to' 
which the participating fum objects; and 

(5) in sufficient detail, the participating fum's 
reasons for objecting to the report's con- 
clusions. 

(d) Objections to proposed recommendations 
of the Committee shall identify the proposed re- 
commendation and shall state the firm's reasons 
for disagreeing with the Committee's proposed 
recommendation in sufficient detail. 

Statutory Authority G.S. 93-12(2); 93-12(8c). 

.0403 REVIEW OF PROTEST 

(a) Within 60 days of receiving an objection 
from a firm, the SQR Advisory Committee shall 
render its determination in response to the ob- 
jection. It may, in its discretion, propose to re- 
commend to the Board that the SQR report be 
amended or alter the recommendation it has 
proposed to make to the Board. 

(b) During its review of any matter raised by 
an objection, the SQR Advisory Committee may 
gather information {Lncluding any review team's 
work papers, checldists, and all other information 
submitted to a review team by a participating 
firm) and conduct interviews, including inter- 
views of members of a review team and/or the 
objecting firm. 

(c) If the firm and the Committee are unable 
to resolve the matter informally, the Committee 
shall submit its recommendation to the Board 
with notice to the objecting fum. The objecting 
firm then has 30 days from such notice to object 
to such recommendation by fihng an objection 
with the Board. The objection shall comply with 
the requirements of 21 NCAC 8M .0402(d) and 
is filed when received by the Board. 

(d) The Board shall review the recommenda- 
tion of the Committee and the objection and 
then, if the matter is not resolved informally, the 
Board may set the matter for hearing pursuant 
to Article 3Aof G.S. 150B. 

Statutory Authority G.S. 93-12(2); 93-l2(8c); 
l50B-2(2): l50B-4l(c). 

•k-k-k-k-k-k-k-k-k-k-k-k-k^-k-k-k-k 



5:15 NORTH CAROLINA REGISTER November I, 1990 



993 



PROPOSED RULES 



ly otice is hereby given in accordance with G.S. 
I50B-I2 that the Midwifery Joint Committee in- 
tends to adopt rule(s) cited as 21 NCAC 33 
.0006. 

1 he proposed effective date of this action is 
March I, 1991. 

1 he public hearing will be conducted at 9:30 
a.m. on December 3, J 990 at the North Carolina 
Board of Nursing Office, 3724 National Drive, 
Suite 201, Raleigh, NC 27612. 

\^ omment Procedures: Any person wishing to 
present oral testimony relevant to proposed rules 
may register at the door before the hearing begins 
and present hearing officer with a written copy of 
the testimony. Written statements may be di- 
rected ftve days prior to the hearing date to the 
Midwifery Joint Committee, P. O. Box 2129, 
Raleigh. NC 27602. 

CHAPTER 33 - MIDWIFERY JOINT 
COMMITTEE 

.0006 NLRSE MIDW IFE APPLICANT STATUS 

(a) The Nurse .Midwife Applicant status may 
be granted by the Midwifen.' Joint Committee to 
a registered nurse who meets all of the following 
stipulations: 

(1) has graduated from a nurse midwifen,^ ed- 
ucation program which meets the criteria 
of the rVmerican College of Nurse 
Midvvives for graduates to seek certif- 
ication; 

(2) has apphed to take or is waiting for results 
of the certification exam; and 

(3) whose application for approval as a certi- 
fied nurse midwife has been received by 
the Midwifery Joint Committee. 

(b) Nurse midwife applicant status may not 
exceed a period of six months beyond date of 
completion of nurse midwLfer>' education pro- 
gram or untU notice of certification is recei%'ed, 
which ever occurs frrst. 

(c) A nurse midwife applicant, described in 
Paragraph (a) of this Rule, may function before 
being approved as a certified nurse midwife in 
accordance with 21 NCAC 33 .0004 and 21 
NCAC 33 .0005, and with the foUowLng limita- 
tions: 

(1) wear identification as a "Nurse Midwife 
Applicant"; 

(2) have no prescribing privileges; 

(3) have no remote practice sites; 

(4) perform his her duties only in situations 
where the super\ising physician is phys- 



ically present in the practice site in which 
the applicant is working; and 
(5) have immediate physician countersigning 
of all medical notations in all patient 
charts in all practice locations. 

(d) In the event the individual leaves the job in 
which he she has worked as a nurse midwife ap- 
plicant before approval as a certified nurse 
midwife is granted, the individual must submit a 
written explanation to the Midwifery Joint 
Committee before he she may apply to work in 
the nurse midwife applicant status in another job. 

(e) The nurse midwife applicant status does not 
apply to an individual previously approved as a 
certified nurse midwife by the Midwifery Joint 
Committee in another practice situation which 
has terminated and who is seeking approval in a 
new job. 

(f) Once the new application has been received 
by the .Midwifer^■ Joint Corrmiittee, the previ- 
ously approved certified nurse midwife may 
function prior to approval of the new job as fol- 
lows: 

(1) wear identification as a "Certified Nurse 
Midwife"; 

(2) use prescribing number previously issued 
by the Board for prescribing privileges; 

(3) have physician countersigning of all med- 
ical notations in all patient charts in aU 
practice locations within 24 hours of Cer- 
tified Nurse Midwife/patient contact. 

Statutory Authority G.S. 90- 178. 2; -90- J 78. 5. 



ly Otice is hereby given in accordance with G.S. 
I SOB- 12 that the North Carolina Board of Nurs- 
ing intends to adopt ndes cited as 21 NCAC 36 
.0501 - .0507. 

1 he proposed effective date of this action is 
March I. 1991. 

1 he public hearing will be conducted at 3:00 
p.m. on December 6, 1990 at the North Carolina 
Board of Nursing Office, 3724 National Dri\e, 
Suite 20 J, Raleigh, NC 27612. 



Co 



omment Procedures: Any person wishing to 
present oral testimony relevant to proposed ndes 
may register at the door before the hearing begins 
and present hearing officer with a written copy of 
testimony. Written statements may be directed 
fn-e days prior to the hearing date to the North 



994 



5:15 NORTH CAROLINA REGISTER November 1, 1990 



PROPOSED RULES 



Carolina Board of Nursing, P.O. Box 2129, 
Raleigh, NC 27602. 

CHAPTER 36 - BOARD OF NLRSING 

SECTION .0500 - PROFESSIONAL 
CORPORATIONS 

.0501 ALTHORITY AND DEFINITIONS 

(a) Chapter 55B of the General Statutes of 
North Carolina, the "Professional Corporation 
Act," authorizes the North Carolina Board of 
Nursing to adopt regulations for professional 
corporations whose purpose is the provision of 
nursing related services. 

(b) The rules in this Section supplement the 
basic statutory law governing professional cor- 
porations and shall be interpreted so as not to 
conflict with such statutory law, as it may be 
amended from time to time, or with other stat- 
utes and laws governing corporations generally. 

(c) "Board" means the North Carolina Board 
of Nursing. 

(d) "Nursing Related Services" means those 
activities through which nursing, as defined in 
G.S. 90-171.20(4), is practiced. 

(e) "Licensee" means any individual who is 
duly licensed to practice nursing in North 
Carolina as a registered nurse. 

(f) "Professional Corporation" means profes- 
sional corporations organized for the purpose of 
providing nursing related services in North 
Carolina. 

(g) "Director" means the Executive Director 
of the North Carolina Board of Nursing. 

(h) "Assistant" means the Administrative As- 
sistant to the Executive Director of the North 
Carolina Board of Nursing. 

Statutorv Authority G.S. 55B-2; 55B-/2; 
90-171.20. 

.0502 NAME OF PROFESSIONAL 
CORPORATION 

The following requirement, in addition to the 
provisions of Chapter 55B, the Professional 
Corporation Act of North Carolina, must be met 
regarding the corporate name: 

The n;mie of the professional corpo- 
ration referred to herein shall not in- 
clude any adjectives or words not in 
accordance with ethical customs of 
the nursing profession. 

Statutorv .Authority G.S. 55B-5; 55B-J2; 
90- 17 1. 43. 

.0503 PREREQUISITES FOR INCORPORATION 



The following requirements must be met in or- 
der to incorporate: 

(1) The incorporator, whether one or more, of 
a professional corporation shall be duly li- 
censed to practice nursing in North Carolina 
as a registered nurse. 

(2) Before the filing of the articles of incorpo- 
ration with the Secretary of State, the 
incorporators shall file, with the assistant to 
the Board, the original articles of incorpo- 
ration, plus a copy, together with a registra- 
tion fee of fifty doUars ($50,00). 

(3) The original articles of incorporation and 
the copy shall be accompanied by an appli- 
cation to the Board (Corp. Form 1) certified 
by all incorporators, setting forth the names, 
addresses, and certificate numbers of each 
shareholder of said corporation who will be 
practicing nursing for said corporation. 

(4) Included with the above shall be a state- 
ment that all such persons are duly licensed 
to practice nursing in North Carolina as a 
registered nurse, and stating that the corpo- 
ration will be conducted in compliance with 
the Professional Corporation Act and these 
Regulations. 

(5) If the articles are changed in any manner 
before being filed with the Secretary of State, 
they shall be re-submitted to the assistant 
of the Board and shall not be fded with the 
Secretary' of State until approved by the as- 
sistant of the Board, 

Statutory Authority G.S. 55B-4; 55B-/2; 

90-l7l.20{6). 

.0504 CERTIFICVTE OF REGISTR.VriON 

The Certificate of Registration shall be issued 
as follows: 

(1) The Director or Assistant shall issue a 
Certificate of Registration (Corp. Form 2) 
for the professional corporation to become 
effective only when the professional corpo- 
ration files the articles of incorporation with 
the Secretary of State and if: 

(a) the Director or Assistant of the Board 
fmds that no disciplinary action, civil or 
criminal legal action, is pending against 
any of the licensed incorporators or per- 
sons who will be directors, officers, or 
shareholders of such corporation; and 

(b) it appears to her that such corporation 
will be conducted in compliance with the 
law and regulations. 

(2) T he proposed original articles of incorpo- 
ration, and the Certitication of Registration, 
will be returned to the incorporators for fil- 
ing with the Secretary of State, The copy 



5:15 NORTH CAROLINA REGISTER November I, 1990 



995 



PROPOSED RULES 



of the articles and a copy of the certification 
will be retained in the office of the assistant. 
If the required findings cannot be made, the 
registration fee shall be refunded to the 
incorporators. 

(3) The initial Certificate of Registration shall 
remain in effect until December 31, of the 
year in which it was issued unless suspended 
or terminated as provided by law. The 
Certificate of Registration shall be renewed 
annually thereafter. 

(4) At least 20 days prior to the date of expi- 
ration of the certificate, the corporation shall 
submit its written application for renewal 
upon a form as provided by the Board 
(Corp. Form 3), said application to be ac- 
companied by check in the amount of 
twenty-five dollars ($25.00) m payment of 
the renewal fee. 

Statutory Authority G.S. 55B-/2: 90-17/ .20(6). 

.0505 GENER.\L AND .ADMINISTRATIVE 
PROMSIONS 

The following general provisions shall apply to 
all incorporating professional associations: 

(1) If the Director or Assistant should decline 
to issue a Certificate of Registration required 
by 21 NCAC 36 .0504 (a)(1), or decline to 
renew the same when properly requested, 
or shall refuse to take any other action re- 
quired of him her in writing by a profes- 
sional corporation, the aggrieved party may 
request, in writing, a re\iew of such action 
by the Board, and the Board shall provide a 
formal hearing for such aggrieved party be- 
fore a majority of the Board and such hear- 
ing shall be at the expense of the aggrieved 
party. 

(2) .All amendments to charters of professional 
corporations, all merger and consolidation 
agreements to which a professional corpo- 
ration is a party, and all dissolution pro- 
ceedings and similar changes in the 
corporate structure of a professional corpo- 
ration shall be filed with the Director or 
Assistant of the Board for approval before 
being filed with the Secretar*' of State. A 
true copy of the changes filed with the Sec- 
retary of State shall be filed with the assist- 
ant of the Board within ten days after the 
same are filed with the Secretary of State. 

(3) The Director or assistant is authorized to 
issue the certificate (Corp. Form 4) required 
by G.S. 55B-6 when stock is transferred in 
a professional corporation, and such certif- 
icate shall be permanently attached to the 
stub of the transferees certificate in the stock 



book of the professional corporation. The 
fee for such certificate shall be five dollars 
($5.00) for each name included in the certif- 
icate. 



Statutory A uthority 
90-ni.20(6). 



G.S. 55B-6; 55B-I2; 



.0506 FORMS 

Tlie following forms may be secured from the 
office of the Board of Nursing regarding profes- 
sional corporations: 

(1) Regulations adopted by the North Carolina 
Board of Nursing relating to Professional 
Corporations whose purpose is providing 
nursing related services; 

(2) Corp. Form 1 - Certificate of 
Incorporator(s) and .Application for a Cer- 
tificate of Registration for a Professional 
Corporation; 

(3) Corp. Form 2 - Certificate of Registration 
of a Professional Corporation for the Pur- 
pose of Providing Nursmg Related Services; 

(4) Corp. Form 3 - Application for Renewal 
of Certificate of Registration; and 

(5) Corp. Form 4 - Certificate Authorizing 
Transfer of Stock in Professional Corpo- 
ration Organized to Provide Nursing Re- 
lated Services. 

Statutory Authority G.S. 558-12: 90-/^J .20(6). 

.0507 FEES 

(a) Initial registration fee of fift\' dollars 
($50.00) is required. 

(b) Fee for renewal of Certificate of Registra- 
tion is twenty-five dollars ($25.00). 

(c) Fee for authorization for transfer of stock 
IS five dollars ($5.00). 

Statuton- Authority G.S. 55B-I0; 55B-II: 
55B-12. 

TITLE 25 - OFFICE OF ST.ATE 
PERSONNEL 

1\ otice is hereby given in accordance with G.S. 
I50B-I2 that the Office of State Personnel State 
Personnel Commission intends to adopt rule cited 
as 25 S'CAC I A .0005 and amend rules cited as 
25 XCAC IB .0436: ID .0509 - .0510, .0707. 

1 he proposed effective date of this action is 
.March I, 1991. 



Th 



he public hearing will be conducted at 9:00 
a.m. on December 6, 1990 at the Personnel De- 



996 



5:15 NORTH CAROLINA REGISTER November I, 1990 



PROPOSED RULES 



velopment Center, 101 West Peace Street, 
Raleigh, North Carolina. 

C- omment Procedures: Interested persons may 
present statements either orally or in writing at the 
public hearing or in writing prior to the hearing 
by mail addressed to Drake Maynard, Office of 
State Personnel. 116 West Jones Street, Raleigh, 
North Carolina 27603. 

CHAPTER I - OFFICE OF STATE PERSONNEL 
SUBCHAPTER lA - GENERAL PROVISIONS 

.0005 COVERAGE OF TITLE 25 

(a) Unless otherwise indicated by specific ref- 
erence to local government employees (as defined 
in 25 NCAC lA .0003), the provisions of Sub- 
chapters IC - IH, IJ - 10 shall apply only to 
apphcants, employees or former employees of 
prinicipal state departments (as defined in 25 
NCAC lA .0003), or a state supported institu- 
tion of higher learning (as defined in 25 NCAC 
lA .0003). 

(b) The provisions of Subchapter II shall apply 
only to employees of local government agencies 
subject to G.S. Chapter 126 (as defined in 25 
NCAC lA .0003). 

Statutory .Authority G.S. 126-4. 

SLBCHAPTER IB -STATE PERSONNEL 
COMMISSION 

SECTION .0400 - APPEAL TO COMMISSION 

.0436 SETTLEMENTS/CONSENT 

AGREEMENTS IN GRIEVANCES, 
CONTESTED CASES 

(a) .Any settlement or consent agreement in a 
grievance or contested case which requires the 
approval and/or processing of personnel action 
forms by the Office of State Personnel must be 
appro\ed by the Office of State Personnel aft4 
tfee Stato Pcri' i onnol Commission before such 
personnel action forms will be processed. Ap- 
proval by the Office of State Personnel shall be 
indicated by the signature of the State Personnel 
Director or his designee in an appropriate place 
on the settlement or consent agreement. This 
provision shall not be construed to require Office 
of State Personnel approval of a settlement in 
which the only portion requiring approval is the 
awardmg of attorney's fees to the employee's at- 
tome)' by the State Personnel Commission. This 
provision shall also not be construed to require 
approval of any settlement the terms of which 
allow an employee to substitute a resignation for 



a dismissal and to withdraw a grievjince or a 
contested case action. 

(b) The provisions of 25 NCAC lA .0004 
(EXCEPTIONS AND VARIANCES) must be 
complied with when any provision of a settle- 
ment or consent agreement in a grievance or 
contested case requires an exception to or vari- 
ance from existing personnel poUcy. This com- 
pliance shall be in addition to the requirements 
of this Rule. Anv settlement or consent agree- 
ment which contams a provision which requires 
an exception to or variance from existing per- 
sonnel policy must be reviewed and approved by 
the State Personnel Commission prior to the 
processing of anv personnel action forms by the 
Office of State Personnel. 

(c) Personnel action forms, required by the 
provisions of any settlement or consent agree- 
ment which has not been approved by the Office 
of State Personnel aft4 or the State Personnel 
Commission as required by this Rule, shall not 
be processed by the Office of State Personnel and 
shall be returned to the agency without action. 

(d) Any settlement or consent agreement which 
does not require action by the Office of State 
Personnel or the State Personnel Commission 
does not require the approval of either body to 
be effective. 

Statutory .Authority G.S. 126-4. 

SLBCHAPTER ID -COMPENSATION 

SECTION .0500 - SEPARATION 

.0509 SEVERANCE SALARY CONTINLATION 

Severance salary contmuation shall be paid to a 
state employee who is terminated as a result of 
reduction in force and for whom there is no 
foreseeable opportunitv for reemployment. This 
policy provides for uniform appUcation of 
severance salary continuation for employees who 
are involuntarily separated due to reduction-in- 
force. Payment is based on total state service 
supplementtfd by an age factor. The age" factor 
recogrdzes that older employees, although pro- 
tected from discrimination on the basis of age, 
do have a more difficult time fmding new em- 
ployment due to lack of transferable skills, cur- 
rent salary le\el, geographic location and other 
factors. 
(1) Eligible Employees: 
(a) A permanent full-time or part-time (20 
hours or o\'er) employee who does not 
obtain another permanent job in state 
government by the effective date of the 
reduction-in-force shall be eligible for 
severance salary' continuation when sepa- 



5:15 NORTH CAROLINA REGISTER November 1, 1990 



997 



PROPOSED RULES 



rated. /\Jso eliable are employees with 
trainee appointments who have completed 
six months of service, and employees who 
attained permanent status pnor to enter- 
ing a tramee appomtment. Ihis shall not 
apply to employees whose reduction-in- 
force is not considered permanent; that is, 
employees who are reducted-in-force on a 
temporary or seasonal basis with the ex- 
pectation that they will return to work 
within twelve months. 

(b) An employee who is separated at the end 
of time-limited permanent appointment is 
not eligible for severance salary continua- 
tion. 

(c) Employees who are separated on early, 
service, or disability retirement or with a 
discontinued service retirement as pro- 
vided by G.S. 143-27.2 are not eligible for 
severance salary continuation. Employees 
who are eligible for early or service retire- 
ment may, if it is to their advantage, elect 
to delay their retirement and receive 
severance salary continuation for the pre- 
scribed period. 

(d) Employees who are reemployed after be- 
ing terminated as a result of reduction-in- 
force and who have previously received 
severance salary continuation payments 
are only eligible to receive the difference 
between previous payments and the cur- 
rent eHgibLlity. 

(e) Employees who are reemployed from any 
retired status with the state and who are 
subsequently tennmated as a result of 
reduction-in-force shall be eligible for 
severance salary continuation without 
credit for aggregate service prior to retired 
status. 

(f) Permanent employees scheduled to be 
separated by reduction-in-force, may ac- 
cept a temporary state position and re- 
main eligible to receive severance salary 
continuation in accord with this policy. 

(g) A permanent employee scheduled to be 
separated through reduction-in-force may 
decline a lower level position and retain 
eligibility for severance salary continua- 
tion. 

(2) /Vmount and .Method of Payment: 
(a) Severance salary continuation shall be 
based on total state sei-vice and supple- 
mented by an age adjustment factor as 
follows: 
(i) .Amount of Salary^ Continuation 
Years of Ser\'ice Payment 

Less than 1 year 2 weeks 

1 but less than 5 years 1 month 



5 but less than 10 years 2 months 

10 but less than 20 years 3 months 

20 or more years 4 months 

(ii) Age Adjustment Factor 

Employees qualify for the age adjustment 
factor at 40 years of age. To compute the 
amount of the adjustment, 2.5 percent of 
the annual base salary will be added for 
each fuU year over 39 years of age not to 
exceed 22 years (age 61). In the event an 
employee is not eligible for either social 
security benefits or retirement benefits 
under the Teachers' and State Employees' 
Retirement System, the employee may 
receive credit for age beyond age 61. The 
total age adjustment factor payment is 
limited by the service payment and cannot 
exceed the total service payments. 
Note: At age 62, a career employee is 
usually eligible for social security benefits 
as well as benefits under the Teachers' and 
State Employees' Retirement Systerh both 
of which have been contnbuted. to by the 
state. 

Example: Age 63; salary - twenty-four 
thousand ($24,000) dollars/year; Service - 
20 years. However, the age adjustment 
factor cannot exceed the ser\'ice factor so 
the age factor is limited to eight thousand 
dollars ($8,000). The total payment is 
sixteen thousand dollars. 

(b) The amount to be paid to part-time em- 
ployees win be calculated using total state 
service multiplied by the prorated 
monthly pay. 

(c) Severance salary continuation wiU be paid 
on a pay penod basis and is not subject 
to employee or employer retirement con- 
tnbutions, and as a result, will not be in- 
cluded in computing average fmal 
compensation for retirement purposes. 

(d) /Vny period covered by severance salary 
continuation shall not be credited as a 
period of state service. 

(e) An employee who is reemployed in any 
permanent position with the state while 
receiving severance salary continuation 
win no longer be eligible for such pay ef- 
fective on the date of reemployment. The 
reemploying agency shall be responsible 
for determining if the former employee is 
receiving severance salary continuation 
payments. 

(f) If an employee dies while receiving 
severance salary continuation, the balance 
of such payment will be made to the de- 
ceased employee's death benefit benefici- 
ary as designated with the Teachers' and 



998 



5:15 NORTH CAROLINA REGISTER November I, 1990 



PROPOSED RULES 



State Employees' Retirement System in a 
lump sum payment, 
(g) An employee receiving severance salary 
continuation is not entitled to receive un- 
employment compensation, 
(h) Funds for severance salary continuation 
will be provided as directed by the Office 
of State Budget. G.S. 143-27.2 provides 
that severance wages are authorized by the 
Director of the Budget, upon written re- 
quest of a state agency and with recom- 
mendation by the State Persormel 
Director when economies in the state 
budget have been achieved. .Ml severance 
payments are contingent upon the avail- 
ability of funds. If funds are not sufficient 
for full payment to all employees, distrib- 
ution of available funds shall be on a 
pro-rata basis such that all employees will 
receive a pro-rated payment in accordance 
with their age and service. In cases where 
the agency is not paying the fuU amount, 
the agency shall submit documentation 
signed by the agency head to the State 
Personnel Director and the State Budget 
Director. 
(3) For each employee who receives severance 
salary continuation, agencies shaU show on 
the separation form. Form FD-105, the cal- 
culation and amount of such payment. 

Statutory Authority G.S. 126-4(10); 143-27.2. 

.0510 PRIORITY REEMPLOYMENT 
CONSIDERATION 

(a) Priority reemployment consideration shall 
be provided to: 

(1) Employees who have met the minimum 
service requirements fof pormant'nt status 
and who occupy or accept and are subse- 
quently separated, for reasons other than 
just cause, from positions designated ex- 
empt as confidential or pohcy-making 
pursuant to G.S. 126- 5(c)(2) and G.S. 
126-5(d)(l). 

(2) Employees with permanent appointments, 
employees and apprentices with trainee 
appointments who have completed six 
months of service, and employees who 
attained permanent status prior to enter- 
ing a trainee appointment, who are sepa- 
rated due to shortage of lunds or work, 
abolishment of a position or other mate- 
rial changes in duties or orgardzation by 
the process commonly known as 
reduction-in-force. .\n employee who is 
separated at the end of a time-Limited ap- 



pointment is not eligible for priority con- 
sideration. 
(b) In affording priority reemployment consid- 
eration, employees separated from policy- 



making/confidential exempt positions for reasons 
other than cause shall receive first priority over 
employees separated by reduction in force. 

(c) The intent of priority consideration for 
employees separated from exempt positions is to 
enable a return to the career service at a salary 
grade equal to that held in the most recent sub- 
ject position. For employees separated through 
reduction in force, the intent is to restore em- 
ployment at a salary grade equal to that held 
prior to separation. In either instance, the salary 
grade and not the salary^ rate is the controllmg 
factor. 



Statutory Authority G.S. l26-5(c)(l); 
l26-5(c)(2): 126-5 (d)(1). 

SECTION .0700 - SALARY RANGE REVISION 

.0707 EFFECTIVE DATE 

(a) S]alar>' incrousos shall b© made e ff e ctiv e ©» 
tbe fifst- day ef tb» pay pt ' riod noarost te^ the ef- 
fuotivQ date &f the suliiP r ' rang e ro^'ision. If funds 
are available and there are no performance or 
personal conduct issues, salary increases to the 
minimum rate (of hiring rat e , tf apphoable) shall 
be given on the effective date of the salary range 
revision. If funds are not available, the increase 
shall be given from the fust available funds and 
made retroactive to the effective date of the salary 
range revision. Employees who are denied an 
adjustment because of poor performance or per- 
sonal conduct may receive the adjustment on a 
current basis if/when performance becomes sat- 
isfactory or the personal conduct issue is re- 
solved. 

(b) Salary increases within the range are op- 
tional and, if recommended, should be given on 
the effective date of the salary range revision. If 
the desired amount of increase is not given on the 
effective date because of unavailable funds, equity 
considerations or performance, the increase(s), 
up to the full allowable amount, may be given 
at a later date(s) on a current basis. Total in- 
creases are Limited to three occurrences and must 
be awarded within 24 months of the original ef- 
fective date of the action. If a subsequent pro- 
motion, reallocation up or down, demotion or 
reassignment occurs, this cancels the authori- 
zation to grant additional increases as a result of 
the previous salary range revision. 

(c) If increases are to be given at later dates, a 
notation must be entered on the form stating the 
reason the increase is being delayed and showing 



5:15 NORTH CAROLINA REGISTER November I, 1990 



999 



PROPOSED RULES 



the dollar amount of the allowable increase, the that this is a delayed salarv' increase. If no in- 

amount given, and the balance that may be given crease is to be given at a later date, no notation 

later. The personnel actions submitted later is necessary. 

must state "Salary Range Revision" increase in 

the description of action block, which will denote Statutory Authority G.S. 126-4. 



1000 5:15 yORTH CAROLISA REGISTER November 1, 1990 



ARRC OBJECTIONS 



1 he Administrative Rules Review Commission (ARRC) objected to the following rules in accord- 
ance with G.S. l43B-30.2(c). State agencies are required to respond to ARRC as provided in G.S. 
l43B-30.2(d). 



ECONOMIC AND COMMLTSITY DEVELOPMENT 

Banking Commission 

4 NCAC 3C .0201 - Establishment of Branch and Limited Svcs Facilities 

Agency Revised Rule 
4 NCAC 3C .0202 - Branch Closing 

Agency Revised Rule 
4 NCAC 3C .0901 - Books and Record 

Agency Revised Rule 
4 NCAC 3C .1301 - Annual Vacation 

Agency Revised Rule 

Community Assistance 

4 NCAC I9L .050/ - Definition 
Agency Revised Rule 

Credit Union Division 

4 NCAC 6C .0203 - Fields of Membership 
Agency Revised Rule 

ENVIRONMENT, HEALTH, AND NATURAL RESOURCES 

Environmental Health 

/5A NCAC ISA .2117 - Water Sanitation and Quality 

Agency Revised Rule 
ISA NCAC ISA .2609 - Refrigeration: Thawing: and Preparation of Food 

Agency Revised Rule 
ISA NCAC ISC .1529 - Point-of-Entry and Other Treatment Devices 

Agency Revised Rule 

Environmental Management 

ISA NCAC 2H .1203 - Public Notice 
Agency Revised Rule 

Marine Fisheries 

ISA NCAC 3C .0311 - Cancellation 

ISA NCAC 3N .0001 - Scope and Purpose 

Agency Revised Rule 
ISA NCAC 30 .0203 - Shellfish Lease Application Processing 

Agency Re\'ised Rule 

Solid Waste Management 



ARRC Objection 7/19/90 
Obj. Removed S/ 16/90 
ARRC Objection 7/19/90 
Obj. Removed 8/16/90 
ARRC Objection 7/19/90 
Obj. Removed 8/16/90 
ARRC Objection 7/19/90 
Obj. Removed 8/16/90 



ARRC Objection 7/19/90 
Obj. Removed 8/16/90 



ARRC Objection 8/16/90 
Obj. Removed 9/20/90 



ARRC Objection 8/16/90 
Obj. Removed 8/23/90 
ARRC Objection 8/16/90 
Obj. Removed 8/23/90 
ARRC Objection 6/21/90 
Obj. Removed 7/19/90 



ARRC Objection 8/ 16/90 
Obj. Removed 9/20/90 



ARRC Objection 9/20/90 
ARRC Objection 8/ 16;90 
Obj. Removed 9/20/90 
ARRC Objection 8/ 16/90 
Obj. Removed 9/20/90 



5:15 NORTH CAROLINA REGISTER November I, 1990 



1001 



ARRC OBJECTIONS 



ISA NCAC I3B .1003 - Eligible Purposes 

Agency Revised Rule 
ISA NCAC I3B .lOOS - Priority Factors 

Agency Revised Rule 
ISA NCAC I3B .1104 - General Conditions 

Agency Revised Rule 
ISA NCAC I3B .11 OS - Permit Required 

Agency Revised Rule 
ISA NCAC I3B .1 107 - Scrap Tire Collection Site Operational Reqmnts 

Agency Revised Rule 

Wildlife Resources Commission 

ISA NCAC lOH .0302 - Minimum Standards 

HUMAN RESOURCES 

AFDC 

10 NCAC 49C .0101 - Eligibility for Coverage 
Agency Revised Rule 

Facility Services 

10 NCAC 3R .2113 - Definitions 

Agency Revised Rule 
10 NCAC 3R .21 IS - Need for Services 

Agency Revised Rule 

Go\emor Morehead School 

10 NCAC 21 A .0301 - Eligibility 
Agency Revised Rule 

"^"outh Senices 

10 NCAC44B .0S04 - Medical Care . - 

Agency Revised Rule 

10 NCAC 44B .0506 - Room Restriction or Confinement 
Agency Revised Rule 

INSURANCE 

Agent Senices Di\'ision 

11 NCAC 6A .0702 - Prelicensing Education Schools 
Agency Revised Rule 

Financial F\aluation Division 

// NCAC I IB .0607 - Application - Employers 

Agency Returned Rule Without Change 
II NCAC I IB .0610 - Application - Groups 

Agency Returned Rule Without Change 

LICENSING BOARDS AND COMMISSIONS 



ARRC Objection 8/16/90 
Obj. Removed 9/20/90 
ARRC Objection 8/ 16/90 
Obj. Removed 9/20/90 
ARRC Objection 8/16/90 
Obj. Removed 8/23/90 
ARRC Objection 8/ 16/90 
Obj. Removed 8/23/90 
ARRC Objection 8/ 16/90 
Obj. Removed 8/23/90 



ARRC Objection 9/20/90 



ARRC Objection 7/19/90 
Obj. Removed 8/16/90 



ARRC Objection 9/20/90 
Obj. Removed 9/21/90 
ARRC Objection 9/20/90 
Obj. Removed 9/21/90 



ARRC Objection 7/19/90 
Obj. Removed 8/16/90 



ARRC Objection 7/19/90 
Obj. Removed 8/16/90 
ARRC Objection 7/19/90 
Obj. Removed 8/16/90 



ARRC Objection 8/ 16:90 
Obj. Removed 9/20,90 



ARRC Objection 8/ 16/90 
9/20 90 

ARRC Objection 8:16 90 
9/ 20; 90 



1002 



5:15 NORTH CAROLINA REGISTER November 1, 1990 



ARRC OBJECTIONS 



Pharmacy 

21 NCAC 46 .1503 - Experience in Pharmacy 
Agency Revised Rule 

Physical Therapy 

21 NCAC4SC .0102 - Responsibilities 

21 NCAC 48C .0501 - Exemption for Students 

PUBLIC EDUCATION 

Elementary and Secondary Hducation 

16 NCAC 6C .0312 - Certificate Suspension and Revocation 

Agency Revised Rule 
16 NCAC 6D .0105 - Use of School Day 

Objection Reconsidered and Failed 

Clincher Motion Passed 

Agency Filed Rule for Codification in the NC.iC 

SECRETARY OF STATE 

Corporations Division 



ARRC Objection 8.1 16/90 
Obj. Removed 8/23190 



ARRC Objection 9/20,190 
ARRC Objection 9/20/90 



ARRC Objection 8/ 16/90 

Obj. Removed 9/20/90 

ARRC Objection 6/21/90 

7/19/90 

9/28/90 



18 NCAC 4 .0101 - Location and Hours 

18 NCAC 4 .0102 - Administration and Functions 

18 NCAC 4 .0205 - Overpayment 

18 NCAC 4 .0206 - Documents Not Specifically Provided For 

18 NCAC 4 .0302 - E.xecution 

18 NCAC 4 .0303 - Rejection 

18 NCAC 4 .0305 - Corrective Filings-Xonprofit Corp' Limited Partnerships 

18 NCAC 4 .0306 - Articles of Incorporation - Nonprofit Corporations 

18 NCAC 4 .0307 - Application For Reservation of Corporate Name 

18 NCAC 4 .0308 - Registered Office and Registered Agent 

18 NCAC 4 .0311 - Art of Merger/ Share Exch /G.S. 55-1 l-07i55A-42.1 

18 NCAC 4 .0312 - Appl For Cert of .Authority 'Foreign Prof Corporation 

18 NCAC 4 .0313 - Filing .Merger Invoking Foreign Corporation 

18 NCAC 4 .0314 - Filing Evidence of Dissolution, Foreign Nonprofit Corp 

18 NCAC 4 .0316 - Form for Annual Report 

18 NCAC 4 .0401 - Documents 

18 NCAC 4 .0402 - Cert of Facts; Certificate of Exit' Authorization 

18 NCAC 4 .0501 - General 

18 NCAC 4 .0502 - Words Prohibited in Addition to Statutory' Prohibitions 

18 NCAC 4 .0503 - Deceptively Similar and Distinguishable Names 

18 NCAC 4 .0504 - Filing Fictitious/ Assumed Name' Foreign Corporation 

No Response Received From .Agency 

Response Received From .Agency 



ARRC 
ARRC 
ARRC 
ARRC 
ARRC 
ARRC 
ARRC 
ARRC 
ARRC 
ARRC 
ARRC 
ARRC 
ARRC 
ARRC 
ARRC 
ARRC 
ARRC 
ARRC 
ARRC 
ARRC 
ARRC 



Object, 
Object 
Object 
Object 
Object 
Object 
Object 
Object 
Object, 
Object 
Object, 
Object, 
Object 
Object, 
Object, 
Object, 
Object, 
Object 
Object 
Object 
Object. 



Obj. Removed 



6! 2 1/90 
6!2l/90 
6/21/90 
6/21/90 
6121/90 
6/21/90 
6' 21 190 
6/21/90 
6/21/90 
6121/90 
6/21/90 
6121/90 
6121:90 
6!21/90 
6'21/90 
6/21/90 
6/21/90 
6':2i:90 
6121:90 
6/21/90 
6/21/90 
7/19/90 
8/16/90 



Securities Division 



18 NCAC 6 .1210 - Securities Exchgs'Auto Quotation Sys .Approve/. Admin 
No Response Received From Agency 
Response Received From .Agency 



ARRC Objection 6^21 ,90 

7/l9i90 

Obj. Removed 8/16/90 



5:15 NORTH CAROLINA REGISTER November I, 1990 



1003 



ARRC OBJECTIOSS 



STATE PERSON>.EL 



25 SCAC IB .0107 - 


Personnel Commission .Meetings 


ARRC Objection 


9:20,90 


25 SC AC IB .0108- 


Commission Staff 


ARRC Objection 


9; 20; 90 


25 SCAC IB .0109 - 


Commission .Actions 


ARRC Objection 


9; 20,90 


25 SCAC IB .0110- 


.Motions 


ARRC Objection 


9:20.90 


25 SCAC IB .01 II ■ 


I 'oting 


ARRC Objection 


9:20.90 


25 SCAC IB .0112 ■ 


Abstention 


ARRC Objection 


9,120 90 


25 SCAC IB .01 13- 


Duties of the Chairman 


ARRC Objection 


9:20. 90 


25 SCAC IB .0114 - 


Order of Business 


ARRC Objection 


9 '20. 90 


25 SCAC IB .0115 - 


Special .Meetings 


ARRC Objection 


9:20 90 


25 SCAC IB .0116- 


Duties of Chairman Bet\^een Meetings of the Comm 


ARRC Objection 


9, 20. 90 


25 SCAC IB .01 r - 


Standing: Special Committees 


ARRC Objection 


9120:90 


25 SCAC IB .01 IS- 


Minutes 


ARRC Objection 


9.20.90 


25 SCAC IB . 0119- 


Sotice of Commission .4 ction 


ARRC Objection 


9:20 90 


25 SCAC J B .01 20- 


Appointment of I 'ice-Chairman 


ARRC Objection 


9 20:90 


25 SCAC IL. 0201 - 


Purpose 


ARRC Objection 


9: 20. 90 


25 SCAC IL .0202- 


Policy 


ARRC Objection 


9! 20:90 


25 SCAC IL .0206 - 


Anti-Dis crim i nation 


ARRC Objection 


9:20 90 


Agency Revised R 


de 


Obj. Removed 


9:21: 90 


25 SCAC IL .0207 - 


Testing and Examination 


ARRC Objection 


9:20.90 


Agency Re\'ised Rule 


Obj. Removed 


9;2I,90 



STATE TREASURER 



Local Go\emment Commission 



20 SCAC 3 .1003 - Petition jor Hearing 

Agency Revised Rule 
20 SCAC 3 .1004 - Hearing Officer 

Agency Withdrew Rule 



ARRC Objection 9.20.90 
Obj. Removed 9 '20 90 

9120 90 



1004 



5:15 SORTH CAROLINA REGISTER iXovember I, 1990 



RULES INVALIDATED BY JUDICIAL DECISION 



1 his Section of the Register lists the recent decisions issued by the North Carolina Supreme Court, 
Court of Appeals, Superior Court (when available), and the Office of Administrative Hearings which 
invalidate a rule in the North Carolina Administrative Code. 



lO.XCAC 3R .0317(g) - WITHDRAWAL OF A CERTIFICATE 

Robert Roosevelt Reilly, Jr., Administrative Law Judge with the Office of Administrative Hearings, 
declared Rule 10 NCAC 3R .0317(g) void as applied in Dawn Health Care, a North Carolina General 
Partnership, Petitioner v. Department of Human Resources, Certificate of Need Section, Respondent (90 
DHR 0296). 

10 \CAC 3R .0317(g) - WITHDRA WAL OF CFRTIFICA TE 

Michael Rivers Morgan, Administrative Law Judge with the Office of Administrative Hearings, de- 
clared Rule 10 NCAC 3R .0317(g) void as applied in Autumn Corporation, Petitioner v. A'.C. Depart- 
ment of Human Resources, Division of Facility Sen'ices, Certificate of Need Section, Respondent (90 
DHR 0321 and 90 DHR 0318). 



5.75 NORTH CAROLINA REGISTER November L 1990 1005 



NORTH CAROLINA ADMINISTRATIVE CODE CLASSIFICATION SYSTEM 



The North Carolina Adrninislralive Code '' NCAC) has four major subdivisions of rules. Two 
of these, titles and chapters, are mandatory. The major subdivision of the NCAC is the title. 
Each major department in the North Carolina executive branch of government has been as- 
signed a title number. Titles are further broken down into chapters which shall be numerical 
in order. The other two, subchapters and sections are optional subdivisions to be used by 
agencies when appropriate. 

TITLE/MAJOR DFV ISIONS OF THE NORTH CAROLFSA ADMIMSTRATI\ E CODE 



OLE 


DEPARTMENT 


LICENSING BOARDS CH 


APTER 


1 


Administration 


Architecture 


2 


2 


Agriculture 


Auctioneers 


4 


3 


Auditor 


Barber Examiners 


6 


4 


Economic and Community 


Certified Public Accountant Examiners 


8 




Development 


Chiropractic Examiners 


10 


5 


Correction 


General Contractors 


12 ■ 


6 


Council of State 


Cosmetic Art Examiners 


14 


7 


Cultural Resources 


Dental Examiners 


16 


8 


Elections 


Electrical Contractors 


18 


9 


Governor 


Foresters 


20 


10 


Human Resources 


Geologists 


21 


11 


Insurance 


Hearing .\id Dealers and Fitters 


22 


12 


Justice 


Landscape Architects 


26 


13 


Labor 


Landscape Contractors 


28 


14A 


Crime Control and Public Safety 


Marital & Family Therapy 


31 


15A 


Environment. Health, and Natural 


Medical Examiners 


32 




Resources 


Midwifery Joint Committee 


33 


16 


Public Education 


Mortuar>' Science 


34 


17 


Revenue 


Nursing 


36 


18 


Secretary of State 


Nursing Home Administrators 


37 


19A 


Transportation 


Occupational Therapists 


38 


20 


Treasurer 


Opticians 


40 


*21 


Occupational Licensing Boards 


Optometry 


42 


22 


Administrative Procedures 


Osteopathic Examination and 


44 


23 


Community Colleges 


Registration 




24 


Independent Agencies 


Pharmacy 


46 


25 


State Personnel 


Ph\sical J'herapy Examiners 


48 


26 


Administrative Hearings 


Plumbing and Heatmg Contractors 


50 






Podiatry Examiners 


52 






Practicing Counselors 


53 






Practicing Psychologists 


54 






Professional Engineers and Land Surveyors 56 






Real Estate Commission 


58 






Refrigeration Examiners 


60 






Sanitarian Examiners 


62 






Social Work 


63 






Speech and Language Pathologists and 


64 






Audiologists 








Veterinar\- Medical Board 


66 



Note: Title 21 contains the chapters of the various occupational Ucensing boards. 



1006 



5:15 NORTH CAROLINA REGISTER November I, 1990 



CUMVLA TIVE INDEX 



CUMULA TIVE LXDKX 

(April 1990 - March 1991) 



1990 - 1991 



Pages 



AO - /Xdministrativc Order 

AG - Attorney General's Opinions 

C - Correction 

FR - Final Rule 

GS - General Statute 

JO - Judicial Orders or Decision 

M - Miscellaneous 

NP - Notice of Petitions 

PR - Proposed Rule 

SO - Statements of Organization 

TR - Temporary' Rule 



ADMINISTRATION 

Auxiliary' Services, 860 PR 

State Property and Construction, 41 1 PR 

ADMINISTRATE E HEARINGS 

Rules Division, 792 PR 

AGRICLLTLRE 

Markets, 737 PR 

Plant Conservation Board, 1 PR 

Plant Industry, 739 PR 

State Fair, 737 PR 

Structural Pest Control Committee, 7 PR 

CORRECTION 

Division of Prisons, 762 FR, 867 FR, 938 FR 



Issue 



1 - 15! 1 - April 

152- 235 2 - April 

236- 285 3 - May 

286- 312 4 - May 

313- 407 5 - June 

408- 473 6 - June 

474- 513 7 - July 

514- 603 8 - July 

604- 635 9 - August 

636- 723 10 - August 

724- 791 11 - September 

792- 859 12 - September 

860- 895 13 - October 

896- 956 14 - October 

957- 1009 15 - November 



5:15 NORTH CAROLINA REGISTER November 1. 1990 



1007 



CVMVLATnE INDEX 



CRIMK COM ROL AND Fl BLIC SAFKTV 

State Hi-hway Patrol, 53 PR, 804 PR 
Butncr Public Safety Division, 419 PR 

ECONOMIC AND ( OMMLMI V I)K\ ELOPMKN 1 

Banking C\)minission, 16 PR 
Community Assistance, 25 PR, 317 PR 
Credit Union, 317 PR, 860 PR 
Hazardous Waste Management, 742 PR 
Milk Commission, 24 PR, 741 PR 

EWIRONMKN I , HEALTH, AM) NA lURAI- RESOURCES 

Coastal Manaizement, 136 PR, 292 PR, 707 PR, 979 PR 

Fnvironmental Manaizement, 54 PR, 193 PR, 420 PR, 542 PR, 706 PR, 744 PR, 912 PR 
Health Ser\-ices, 190 PR, 565 PR, 816 PR, 860 PR 
I and Resources, 744 PR 
Marine Fishenes, 63 PR, 484 PR, 805 PR 

Wastewater Treatment Plant (Operators Certification Commission, 551 PR 
Water Treatment Facility Operators Board of Certification, 621 PR, "^83 PR 

Wildlife Resources and Water Safety, 137 PR, 206 PR, 293 PR. 349 PR, 438PR, 563 PR, 748 PR, 815 PR, 
924 PR 

EESAE DECISION EETIERS 

Voting Rights Act, 241, 286, 316, 605, 638, 792, 957 

FINAL RLLES 

List of Rules Codified, 143 FR, 226 FR, 302 FR, 463 FR, 587 FR, 710 FR,S42 FR. ')44 FR 

GOVERNOR/Ll. (,()> ERNOR 

Executive Orders, 236, 313, 408, 474, 514, 604, 636, 724, 896 

HUMAN RESOLRCES 

Aging, Division of, 704 PR 

DniETCommission, 870 FR. 939 FR 

Facility Services, 516 PR. 702 PR. 95S PR 

Health Services. 152 PR, 245 PR 

Medical Assistance, 191 PR, 911 PR 

Mental Heahh, Developmental Disabilities and Substance Abuse Scr\-iccs, 29 PR, 318 PR, 475 PR, 898 PR 

Ser\iees for the Blind. 412 PR 

Social Services, 247 PR, 607 PR, 976 PR 

Water Treatment Facility Operators Board of Certification, 27 PR 

Youth Scr\iccs, 261 PR 

INSURANCE 

Actuarial Ser\4ces Division, 480 PR 

Agent Services Division, 321 PR, 520 PR 

Fngineering and Building Codes, 793 PR 

Financial Evaluation Division. 342 PR. 525 PR 

{•ire and Casualty Division. 335 PR, 478 PR. 7^6 PR 

Life: Accident and Heahh, 264 PR. 2S7 PR, 52^) PR. 798 PR 

JUSTICE 

.Attorney Gener;il. Office of the. 192 PR, 273 PR 

Criminal Justice Education and Training Standards Commission, 704 PR 

Sheriffs' Standards Dnision. 608 PR 

LICENSING BOARDS 

Certified Public Accountant Fx;uniners, 983 PR 

Cosmetic Ail lixaminers. Board of, 355 PR, 708 PR, 927 PR 



1008 5:15 NORTH CAROLINA REGISTER November I, 1990 



CUMULA TIVE INDEX 



Electncal Contractors, Board of Examiners of. 356 PR 
Medical Examiners, Board of, 207 PR, 838 PR, 862 PR 
Mid\\ifer\" Joint Committee, 994 PR 
Mortuarv Science, Board of, 749 PR 
Nursing,' Board of, 300 PR, 496 PR, 994 PR 
Nursing Home Administrators, Board of, 750 PR 
Physical Therapy Examiners, Board of, 443 PR 
Plumbing and Heating Contractors, Examiners, 621 PR 
Practicing Psychologists, Board of, 755 PR 
Real Estate Commission, 625 PR, 863 PR 

PUBLIC EDUCATION 

Elementary and Secondary', 141 PR, 275 PR, 351 PR 

RE^ENUE 

Individual Income Tax, 359 FR 

License and Excise Tax Division, 445 ER 

Sales and Use Tax, 213 FR, 453 FR, 872 FR 

SECRETARY OF STATE 

Corporations Division, 489 PR 

Secunties Division, 293 PR, 495 PR, 927 PR 

STATE PERSONN.EL 

State Personnel Commission, 277 PR, 500 PR, 756 PR, 996 PR 

STATE TREASURER 

Department Rules, 352 PR 

Local Go\cmment Commission, 352 PR, 442 PR 

Solid Waste Management Capital Projects Financing Agency, 354 PR 

STATEMENTS OF ORGANIZATION 

Statements of Organization, 639 SO 

TRANSPORTATION 

Hiahwavs, Division of, 765 FR, 883 FR 

Motor Vehicles, Division of, 222 FR, 773 FR, 943 FR 



5:15 NORTH CAROLINA REGISTER November I, 1990 1009 



NORTH CAROLINA ADMINISTRATIVE CODE 

The full publication consists of 53 volumes, totaling in excess of 15,000 pages. It is supplemented monthly 
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